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Rebuilding Institutions
Radiant’s Unique Business Model
Abhay Soi Chairman & Managing Director, Radiant Life Care Pvt Ltd
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Contents
VOLUME 09 ISSUE 11
lead interview
08- Towards a Healthier
Tomorrow Shri Oommen Chandy, Chief Minister, Kerala
Cover Story
12
12- Radiant Life Care Redefining Healthcare Excellence Abhay Soi, CMD of Radiant Life Care
18- Technology for Life health it
44- Ending red-tapism need
of hour Dr Jagdish Prasad, Director General of Health Services, Union Ministry of Health & Family Welfare
46- Health Sector Gets IT Push in Kerala Dr K Elangovan, Health Secretary, Kerala
49- IT Smoothens Health
Services Sujata Saunik, Principal Secretary, Public Health Department, Government of Maharashtra
view point
52- Technology in Healthcare
Maharashtra Initiatives and Success Stories Dr Sailesh Puntambekar, Managing Director, Galaxy Care Hospital, Pune
54- Healthcare Insurance
Should be Inclusive Joy Chakraborty, COO, P D Hinduja Hospital & Medical Research Centre, Mumbai
58- Nihon Kohden becomes the Market Leader
event preview
62- India’s Premiere Hospital Infrastructure Show Returns
company profile
10- Samsung Health and Medical Equipment
20- Rosalina Instruments 26- Nihon Kohden India Pvt Ltd 28- PALASH Healthcare Systems Pvt Ltd 30- AGFA Healthcare India Pvt Ltd 34- Komega Impex 36- Maquet Medical India Pvt Ltd 38- MRK Healthcare Pvt Ltd & Nulife
Hospital news
Global Medical Devices Pvt Ltd
56- Doctors Perform First Day-
40- Hospaccx Healthcare Business
Care Angioplasty on 55-Year-old
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news
NOVEMBER / 2014 ehealth.eletsonline.com
Consulting Pvt Ltd
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asia’s first monthly magazine on The Enterprise of Healthcare volume
09
issue
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NOVEMBER 2014
President: Dr M P Narayanan
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ehealth does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors. The magazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. ehealth is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Dr Ravi Gupta, Printed at Vinayak Print Media A-29, Sector-8, Noida, UP, INDIA & published from 710 Vasto Mahagun Manor, F-30, Sector - 50, Noida, UP. Editor: Dr Ravi Gupta © All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic and mechanical, including photocopy, or any information storage or retrieval system, without publisher’s permission.
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editorial
Poised for Healthy Growth One of the sectors witnessing bursting growth in recent times is healthcare. Driven by rising population, increasing income levels, escalating lifestyle-related health issues, improving health insurance penetration and growing private investment, healthcare sector promises to touch more highs in the days ahead. Studies suggest the Indian healthcare industry is well on its way to touch a CAGR of 15 percent to hit USD 250 billion by 2020, from USD 58.2 billion in 2014. In addition, clearance to raise the FDI limit in the insurance sector to 49 percent by the Government is expected to help both the patients and the industry. Also adding to the growth of healthcare sector is blooming of the medical tourism segment, which has seen generous private sector investments, taking the country a step closer to becoming a global healthcare hub. And, blessed with natural resources, Kerala – God’s Own Country – has a decisive edge in medical tourism over the rest of India. However, given the higher purchasing power of urban dwellers, almost 70 percent of the healthcare infrastructure is located in the top 20 cities of India. As the per-capita urban-rural divide looks imminent to stay in the foreseeable future, innovations in healthcare products and delivery methods seem the way forward to reach out to the medically-excluded masses. Fast-catching up terms like e-healthcare, m-healthcare and telemedicine perhaps point in the same direction. Increasing rural mobile phone penetration and fast-spreading Internet network are already forecast to play a crucial role in this regard. In keeping with the global trend, the government has also set out on e-health services course, aimed at boosting health awareness among the rural masses. e-health services include helping people contact and interact with good doctors, buying medicines and taking e-prescriptions. Growing at a healthy rate, the e-health services are expected to start contributing about 2 percent in the overall healthcare sector soon. To showcase the immense potential and abundant opportunities in the sector, the second-largest employer in the service sector, the 10th eINDIA 2014 Summit (http://eindia.eletsonline.com/2014/) in Kovalam Kerala (14-16 November), will have a dedicated health track. Key leaders from the Centre, State governments, Industry and Academia will gather in the august presence of Kerala Chief Minister, Shri Oommen Chandy, and discuss ways and means to facilitate an unhindered growth of the healthcare sector. Stay healthy. Stay fit.
Dr Ravi Gupta ravi.gupta@elets.in
November / 2014 ehealth.eletsonline.com
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health IT
Towards a Healthier Tomorrow
Starting his political career with Kerala Students Union, which he served as President from 1967 to 1969, Shri Oommen Chandy is now a 10-time legislator and currently serving his second term as the 21st Chief Minister of the State of Kerala. Prior to being sworn in as the Chief Minister first time in 2004, he was also part of four different governments holding diverse portfolios, apart from holding several constitutional positions. In an informal conversation with Elets Technomedia CEO and Editorin-Chief, Dr Ravi Gupta, Nayana Singh and Kartik Sharma of ENN, the septuagenarian politician reflects on the strides Kerala has made in various fields, including healthcare
How do you visualise changes in your department through IT? IT has a major role in any large department, particularly the Public Health Department, as we have a large manpower and also because the Government of India and the Ministry of Health is coming up with new programmes to bridge the gaps in public health service delivery every year. IT is an important tool for good governance.
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How do you see the role of IT in promoting citizen services? India today has become tech savvy and that is can be evidently seen in the youth who use mobile phones to spread information at a vast level, through social networking etc. IT can be used to spread messages and awareness at a fast pace and on a large-scale. In the health sector, one can download information about a disease, it cure, prevention and also know where to get examined, all on the click of a button. That is the power of IT and the good thing for the government today is that they can spread information at a much faster sped compared to the earlier days. The other advantage is getting the information that one has missed out on. One can simply type and the information is there in front of him. I feel that information accessibility has touched new levels and only a citizen who is aware of the technological changes going around him would be able to individual seeks medical reimbursement, whether the reimbursement is for him or for his family, what is the disease that he seeks reimbursement for, etc. All this will give us a view of the disease profile of an individual. Once the information is gathered we can spread awareness on prevention, cure and a whole lot of other things.
Do these initiatives depend on private service providers also? No, we rely on MahaOnline and the IT Department, which have been of great support. Recently we requested purchase of tablets for senior officers so that they can access information and store data when needed. Going paperless is one of our key focus areas. When a fire broke out in the Mantralaya, we lost a huge number of records all on paper, but once one goes digital, the storage space required would be much less, one can access and re-access information as many number of times required.
Healthcare is one of the most important issues in today’s Kerala‌ So, we are planning a host of healthcare programmes. We intend to provide free healthcare services to the common people, including free medicines and other facilities Collaborating with private entities requires a lengthy process. So, rather than floating tenders for the private players, it is better to make use of your own IT Department.
Is capacity building a concern in implementing such technologies? Yes, it is a concern, but we don’t have any initiatives as of now but we have been giving training to different cadres for the ongoing processes. Training requires both budget and time, so currently as Maharashtra elections are at hand, we are giving only need-based training at the moment. From next year, we will be having a more coordinated training policy in place.
Any suggestions for enhancing the use and scope of these technologies? What works best for us in these situations is insisting people to do it and not leaving it as an option. In order to make IT a part of our office life, one can follow the examples of young people in the corporate sector, who with their laptops, tablet and mobiles are always connected, and hence their productivity is very high. But, for the same to happen in the government, it is necessary to provide the right environment. For example, one is able to use laptop and tablets at airports and airplanes freely, as Wi-Fi is freely available there; but imagine doing the same in a local train. To enable such services, one needs to have an environment and the right facility.
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company Profile I
Samsung Health and Medical Equipment Company Details Vice President: Dinesh Lodha Health and Medical Equiment Division, Samsung India Electronics Pvt. Ltd. (Health & Medical Equipment division) Office Address: 3rd floor, Vipul Tech Square, Sector-43, Golf Course Road, Gurgaon- 122002 Telephone: +91-124-4881234 Website: www.samsung.com/in/healthcare E-mail: hme.marketing@samsung.com Helpline: 180030108282 & 18002668282(MTNL & BSNL)
Dinesh Lodha Company Profile Samsung provides a consistent cross-channel experience and increases healthcare touch points for expanded services. In India, we currently have three major product lines in healthcare - ultrasound, in vitro diagnostics and digital radiography. Besides medical equipment, we also cater to the healthcare providers through Samsung Enterprise Business, which provides an array of services and solutions that can be tailored across industries. Samsung offers a diverse range of products and solutions spanning from air conditioners, mobile devices and solutions, display and IT solutions, which along with our healthcare products and solutions can provide an integrated and one-stop solution for hospitals, nursing homes, diagnostics chains, and such. We are leveraging our strengths in technology and R&D to offer products that are easier to use, quick and accurate in diagnosis yet have a slim and stylish design. By upholding customer values as its top priority, Samsung is focusing on time engineering that enhances the efficiency of all products being used in hospitals and clinics. Apart from our wide-ranging products and solutions, Samsung also provide consistent crosschannel experience and healthcare touch points for expanded services. Our tablets, smart phones, printers, note PCs and system air conditioners reduce operational costs through increased flexibility and energy efficiency. Samsung has introduced advanced solutions to help in improving the efficiency in OPD & IPD, such as Patient Companion™, a Wi-Fi based bedside nurse call system with a motivational dashboard for patients. This solution will replace the archaic bell and helps to save nurses’ time. The nursing head (warden) can also track the position of nurses and their workload with this application. In addition, Samsung has introduced CARE Q™, positioned as a low cost mobile station to utilize time of patients, while waiting in the OPD. It helps to cut the queue, engage patient, Empower doctor and Track OPD.
Products and Services • Ultrasound • Digital Radiography • In-vitro diagnostics
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• System Air Conditioners • Mobility devices : Tablet & Mobile • Display: Video Wall, Large Format Display, LED etc. • Healthcare solutions
company Profile I
Rosalina Instruments Company Details Managing Director and CEO: James Mazarello Management Team: Rony Fernandes Number of Employees: 20 Head Office Address: 127, Bussa Udyog Bhavan, Tokershi Jivraj Road, Sewri, Mumbai – 400015, India Telephone: +91-22-24166630 / 24173493 Website: www.rosalina.in E-mail: support@rosalina.in Customer Support helpline Number / After Sales Support: +91-22-24166630 / 9619893851 Contact Person: Rony Fernandez Email: rony@rosalina.in Contact No.: 9833286615
Company Profile We have been a major partner in the field of Radiotherapy Quality Assurance, Radiation Protection & Laboratory Equipments for over two decades. The reason why we have chosen manufacturers like Sweden, Standard Imaging, USA, Lap Lasers, Germany, Advanced Instruments, USA is they always had the reputation of providing innovative and leading edge technology, outstanding application support and reliable service back up and a major contribution to our growth. Our office is centrally located in the Commercial capital of India, “Mumbai” formerly Bombay, with an easy access to major hospitals, cancer clinics and BARC facilities. We have a team of qualified, trained calibration facility that enables us to meet the demands of customers throughout India. Our goal for the future are simple, support the customer to achieve success, using our experience to grow on the success already achieved, rectify our mistakes and make Rosalina Service world class. This will ensure that Rosalina continues as an industry leader in exceeding customer expectation.
Products and Services
Turnover
• Osmometer : Make - Advanced Instruments, USA • Viscometer : Make – RHEOAENSE INC, CA
• 2010 – 2011 (Cr.) 5 cr • 2011 – 2012 (Cr) 5.5 cr • 2012 – 2013 (Cr.) 6 cr
Top 5 clients in India • • • • •
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Dr Reddy’s Laboratories Ltd Emcure Pharmaceuticals Sun Pharmaceuticals Ltd Cadila Healthcare Ltd Aurobindo Pharmaceuticals Ltd
November / 2014 ehealth.eletsonline.com
USP Advanced 3250 Single – Sample Osmometer Superior Accuracy and Reliability in Two Minutes. Model A20 Advanced Autometed Osmometer Complies November / 2014 21CFR Part II ehealth.eletsonline.com
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cover story
Radiant Life Care Redefining Healthcare
Excellence
Abhay Soi, CMD of Radiant Life Care,
is firm on bringing about a turnaround in quaternary healthcare. Country’s two iconic hospitals – New Delhi’s BLK Super Speciality Hospital and Mumbai’s Nanavati Super Speciality Hospital – which Abhay’s firm Radiant Life Care manages stands testimony to his commitment. Collectively these two hospitals – both inaugurated by India’s first Prime Minister in the 1950s – have 1000 beds and Abhay has plans up his sleeves to scale this up to 2600 beds, which shall make Radiant one of country’s biggest health care management firms. A finance whiz kid, Abhay has come a long way since his initial years at Anderson where he helped in setting up their financial restructuring business and then his stints at E&Y and KPMG where he led the restructuring services teams. Prior to Radiant, Abhay also co-founded a USD 300 million Private Equity fund
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BLK Super Speciality Hospital
Your specialization has been consultancy in restructurings, turnarounds and later Private Equity, how did you enter the healthcare sector? Our entry into the healthcare delivery sector was partly by design and substantially by default. In 2008, while we were wrapping up our special situations fund due to the shift in such opportunities to the US and Europe, we had identified healthcare and education as sectors of interest. At that time we got an opportunity to assist in the restructuring and turnaround of IHHS, India a company involved in redeveloping, operating and managing Dr BL Kapur Memorial Hospital. During the course of this exercise the erstwhile promoters of IHHS, India wanted to explore an exit. We acquired the company for USD 40 million and renamed it Radiant Life Care. The trustees of Lahore Hospital Society were familiar with us and encouraged our stepping into the shoes of an operator.
Please tell us about your business model. We are clear that we are establishing Institutions, which are also commercially viable, rather than a chain of multi speciality hospitals or multiplying our bed capacities. In Delhi, BLK Super Speciality Hospital is a 650-bedded facility, which we are expanding by
Nanavati Super Speciality Hospital
With commissioning of BLK Super Speciality Hospital, Radiant has registered immense growth and established itself as a unique model in the healthcare delivery sector another 900 beds over the next 5 years. In Mumbai, Nanavati Super Specialty is a 350-bedded facility, which is to be expanded by another 500 beds. We have avoided imposing our own brand name by suffixing or prefixing the same, so as not to dilute the legacy of these institutions. In fact one of the first steps we took was to engage Alok Nanda, a firm specializing in brand architecture for urban infrastructure to help us articulate our aspirations through our logo and brand identity. In my mind institutions across sectors have certain criteria such as fulfilling social needs of that time, being multi-disciplinary, melting pot for talent, possessing state-of-the-art technology, strong focus on academic, research and in some measure having a history of service. Consequently, most institutions are either state funded or dependent on grants for their survival. We believe health care institutions are not only viable but commercially at-
tractive propositions. However, there are certain conditions such as location, size and people-connect, perhaps in that order, that are essential. Location is a key imperative for setting up viable healthcare institutions. On the demand side, metros have the highest purchasing power, growing healthcare issues and lifestyle diseases and the highest shortage of beds in relation to population. On the other hand, not only does the largest and best pool of clinical talent choose to reside in metros but also deployment of high cost technology is most viable there. Delhi and Mumbai are not only the two most attractive cities for healthcare providers in India but we are now present in arguably the best micro markets within these metros. As healthcare issues become more complex, they require an inter-disciplinary approach. Hosting multiple specialities of reasonable critical mass necessitates large bed inventory at single locations. A successful cardiac sciences programme or an established Oncology or Neuro-centre themselves would require an inventory of 100 to 150 beds each. How would you be able to address requirements for Orthopedics, Solid Organ Transplant program, Digestive and Liver Diseases, Mother and Child program, etc if the bed strength is less than 600 to 700 beds. Case in point was the 18-hour nonstop procedure performed successfully by 40 of our super-specialists across six specialities on 10-month old Nigerian
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cover story
conjoint-babies. The fact that we hosted so many specialities under one roof was essential to undertake this procedure. An important characteristic of an institution, especially an healthcare institution, has to be people’s faith in it. This faith gets established over years and matures over generations. It helps if the place has been around for a while rather than having to build that faith and confidence from scratch. Interestingly, Pandit Nehru laid foundation stone for both BLK and Nanavati in the 1950’s and both these institutions have a legacy of serving citizens in their regions for decades now.
How are you geared to win? Our business model is different from most healthcare providers. I also be-
markets for another 3 years. My background as a turnaround specialist and private equity enables me to undertake distressed transactions which are inherently undervalued and provides me both an understanding and access to capital.
8 months of our existence and are in line for JCI in the current year. On the other hand our Occupancy, Revenue and EBITDA has increase by CAGRs of over 40%, 55% and 100% respectively since commissioning in 2010. Are we satisfied? Not in the least.
Radiant has enjoyed phenomenal success and has an enviable track record with BLK Super Speciality Hospital. Are you satisfied?
For how much did you acquire BLK Super Speciality and now Nanavati Super Speciality hospital?
I am an outsider in the business who initially brought learnings from other sectors and objectivity to the table. First few years there was both skepticism and apprehension amongst both clinicians and management to join
We have not acquired either facility. We have entered into Operations and Management arrangements with Trusts which continue to own the facilities both movable and immovable. Under this arrangement, we assist in developing, financing, managing and operating hospitals in accordance with the trusts objectives. Most of the hospitality players, both domestically internationally, operate under Operations and Management arrangements and many hospitals under the larger corportate chains of hospitals in India are managed in the same manner. However, there is a slight difference. We do not impose our brand on these properties but build on the legacies of these institutions by reintroducing them in contemporary avatars.
What made you choose Dr Balabhai Nanavati Hospital?
Asia’s 1st Cyberknife VSI at BLK Super Speciality Hospital
lieve it is necessary to have an appropriate capital structure to attain this vision. In the first 5 to 7 years of the life cycle of each healthcare institution it is important that leverage is low and source of capital is neither private equity nor public in order to set up the fundamental building blocks of values which have long gestation periods but significant upfront costs. One cannot be on a quarterly treadmill being forced to compromise long term values for short and medium term gains. At Radiant, we do not encourage leverage and would not consider public
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me. Over the years, however, we have been able to establish our reputation of being transparent, forthright and employers of choice within the sector. Consequently, we are enjoying both financial and reputational success whether by winning the gold award in the Asian Health Care Awards 2013, 2014 amongst over 300 entries from 9 countries or being named among the top 10 multi speciality hospitals in the NCR region consistently or winning the Lumen Award for fastest response in acute heart attacks. We obtained NABH accreditation within the first
Dr Balabhai Nanavati Hospital is truly an iconic institution in Mumbai, intricate to both its history and social fabric. The foundation stone of the hospital was laid by Pt Jawaharlal Nehru and Mahtama Gandhi visited the facility to bless it. On Gandhi Ji’s request request the first patient at the hospital was a harijan. Mother Teresa inaugurated the cancer centre and was even admitted for ailments to the hospital a few times. Even today the Sisters of Charities bring the destitute to the hospital who are looked after free of cost. So many in the city and region have pleasant memories of being looked after with compassion here. Besides its rich legacy, the location, pool of skilled clinicians and workforce,
ability to scale up in near future were attractive propositions. In terms of technology, it has amongst the best facilities in Mumbai including 10 modular OT’s, 3 Tesla MRI, 4D sonography and a brand new cath lab. In all it fulfilled all the criteriaof being a long lasting institution. Any healthcare provider would be immensely proud to be associated with such legacy. I am happy that the trustees reposed their faith in our abilities and chose us subsequent through a long drawn screening process in which almost all major healthcare players had participated.
What all learnings and achievements do you seek to acquire while working along with Nanavati Super Speciality hospital? All sorts. We look forward to a fruitful journey along with all stakeholders such as clinicians, management, workers and most importantly the patients. I hope this journey is both a source of learnings and achievments in all aspects, and only then would it be truly rewarding and fruitful. We have now reintroduced Dr Balabhai Nanavati Hospital as Nanavati Super Speciality. In doing so we have stated our aspiration and pledged a high end quaternary care facility.
Tell us about the charitable work at Nanavati. The Charity Commissioners Aact in Maharashtra necessitates 10% of beds for free services and another 10% for subsidized services to indigent patients with overall cap of 2% of revenues. At Nanavati the extent of free services has always exceeded their obligations. We not only intend to help continue this practice but through expansion would be increasing the total extent of charitable obligations to the underprivileged.
Has there been any change in organizational hierarchy and authority, If yes what are they? None really. The trust continues to manage its own affairs through its
Renovated cathlab at Nanavati Super Speciality Hospital
erstwhile trustees, executive council and office bearers and remains in ownership of all assets and employer of personnel while we strengthen management, institutionalize processes, introduce state of the art technology and global best practices, infuse financial resources and help raise finance. The chairman of the board of trustees Mr Priyam Jhaveri is truly a forward looking individual.
What are the challenges faced by the BLK Super Speciality Hospital at the moment and how do you plan to resolve it?
We have entered into Operations and Management arrangements with Trusts at both BLK Super Speciality Hospital and Nanavati Super Speciality Hospital which continue to own the facilities both movable and immovable. Under this arrangement, we assist in developing, financing, managing and operating hospitals in accordance with the trusts objectives
People development is amongst the most important challenges that we foresee for ourselves. We initiated a program for leadership development in October 2012 with very positive outcomes. We are now working to take this to the next level of management to inculcate the strong culture of our Institution further downstream.
What is the role of IT in various medical procedures and also hospital administration? IT is an integral part of our clinical and administrative functions and not just a support department to capture raw data. We believe in deploying technology to have consistent process outputs across functions and to maximize people effectiveness. We have a very strong IT backbone with complete virtualization, which is one of its kinds in healthcare industry. We are putting Gigabyte network for faster response across the hospital. We have top of the line HIS, seamlessly connected to Microsoft Navision for all backend functions. We will be going live with our new PACS solution and CRM application. Helpdesk for Internal customer is our in-house creation, an innovative usage of technology, for which we won Gold Award at Hospital Management Asia in 2013.
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cover story
What are the latest initiatives introduced at BLK Super Speciality Hospital? While our legacy value system forms the bedrock of our business, we are a constantly learning and evolving organization. We are working on many initiatives at this time. To further enhance patient safety we have regular clinical audits. We have developed a working antibiotic policy for our hospital to reduce the chances emergence of microbial resistance. On the administrative side, we rolled out an organization wide program to empower our front-line employees. This program won the Gold Award by Hospital Management Asia in 2014. Employee engagement, team work, collective celebration are other areas where we work intensively with our people.
What latest technologies have been introduced in medical and surgery procedures at BLK Super Speciality Hospital? Our constant endeavor as health care institutes is to be abreast with latest technology for the benefit of patients. We have recently acquired Blood Irradiator that is one of its kinds in the country. We have installed a biplane Cath-lab for our Neuro intervention and Pediatric cardiac program. High Definition minimally invasive instruments for surgical procedures along with plasma sterilizers for safe and effective cleaning are some of the other recent additions. Both the institutes, BLK and Nanavati, are poised to be at the forefront of clinical care in India.
Where do you see BLK Super Speciality Hospital 5 years from now? BLK has been Delhi’s fastest growing hospital and each year we have operationalize and filled close to 100 additional beds. Year on year highly specialized programs are being rolled out ever since we took over O & M, and I believe these programs have consolidated in form of true centres of excellence in the
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Central Lobby, BLK Super Speciality Hospital
region. Over next 3-5 years BLK shall be one of the most preferred Healthcare providers in Solid organ transplants, Undisputed leader in Oncology & Hematopoietic stem cell Transplants, Advanced Laparoscopic, Minimal Access and Robotic Surgery and Digestive and Liver diseases. We are nurturing various sub-specializations under the umbrella of Cardiac sciences, Orthopedics, Neurosciences and Plastic and reconstructive Surgery as the rapid developments in these specialization have necessitated novel approach to structurethese disciplines. I see BLK Super Speciality Hospital emerging as one of the most prominent healthcare institutions with very robust clinical programs and matching resources in form of infrastructure, technology and people.
What are you future plans in terms of development and growth of BLK Super Speciality Hospital? BLK is poised for exponential growth over next 3-5 years hence we will be busy creating infrastructure and acquiring technology. A lot of growth shall also happen inorganically so we will also be increasing the team size in both clinical and support areas. We have already engaged architect and design firm for the expansion work, the zoning and block planning has been completed and we are cur-
rently completing the detailing for clinical areas.
What are your expectations from the new government? Government should help establish India as a hub for medical tourism globally. Rising at a CAGR of 18%, Medical Tourism is estimated to be USD 32 Bn over the next 5 years. While India is the largest providers of doctors, nurses and technicians to the world and is also the most cost effective in healthcare delivery, however, in-spite of inherent comparative and competitive strengths, India attracts less than 3% of global Medical Tourism traffic. This is primarily on account of lack of promotion and procedural impediments. On one hand we have been unable to effectively promote India as a viable healthcare destination due to a absence of cohesive marketing strategy, and on the other hand there continues to be hurdles to consumers in the form of high visa fee, cumbersome processes, certification requirement by embassy doctors, visit to police stations, etc. BJP led Government at the centre has already been talking of 5Ts to harness the true potential of India - Talent, Tourism, Trade, Technology and Tradition; Medical tourism is anchored on these 5Ts itself. Government should remove impediments and promote India as healthcare destination worldwide to gain a larger share of global medical tourism traffic.
special feature
New scientific methods for treatment of diseases plaguing the mankind since ages are increasingly being used by doctors across the globe which is, in turn, reshaping the face of medical equipment industry. Neha Thakur of ENN delves deep into the changes brought in by technology in medicine
O
f late, the huge growth opportunities and the advent of science within the domestic and global healthcare sectors have attracted enough attention and also income in the health industry. Indeed, the Indian Healthcare system has notched up several significant achievements over the last 10 years particularly in terms of life expectancy, controlling infant mortality rate and attaining ample success in coping with various fatal diseases and epidemics haunting people since ages. However, easy accessibility of quality healthcare and affordability to the citizens still remain the focus of Indian health ministry. The sudden boom of health sector is expected to aid foreign companies to understand the Indian capabilities for investing in the health sector. Indeed, technology in the last two decades has revolutionized the way Indian healthcare is not only perceived but also delivered worldwide. It has greatly aided patients and providers alike by enhancing the quality of delivery, services, reduction in turnaround time of workflows and thus the overall cost, besides bringing in higher accountability into the system. Constant advancements in the field of medical technology are playing a great role in safeguarding and improving the quality of our lives.
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Technology
for Life The influence of medical technology is all pervasive and its positive impact is not limited to the higher privileged sections of the society but has also helped the poorer lot in reducing IMR (Infant Mortality Rate),
MMR (Measles, Mumps and Rubella vaccine), following usage of right technology like incubators, warmers, better operation and surgery equipment. The wealth of clinical material to be learned in India is actually vast
beyond words; the exposure that a young doctor acquires here is quite phenomenal. Because of the diversity of our population, there always remains a broad spectrum of diseases, including infectious diseases like malaria, dengue, filariasis, tuberculosis, and leprosy. As medical treatment costs in the developed nations are unimaginably high, today more and more foreigners are finding the prospect of international travel for medical care increasingly appealing. Around 150,000 people across the globe travel to India each year seeking low-priced healthcare procedures. Medical tourism is a growing sector in India too and the medical tourism sector is expected to gain an annual growth rate of 30%, making it a big industry by next year. We also have an expanding urban population; hence, we also see chronic health problems that plague the western countries since long like cardiovascular diseases. Because consanguinity is common in some Indian communities, we very often get to witness several rare pediatric syndromes, some of which have never been reported in western countries like the unusual variations of Escobar syndrome. With rapid advancements and developments taking place in almost every field you can imagine, it is impossible that health and medicine
“Holistic approach towards a patient treatment must be focused today. Repetitive Transcranial magnetic stimulation therapy has been partly useful in treating chronic depression. Procedures for major mental diseases like OCD (obsessive compulsive disorders) are treated with usage of ‘Gamma Knives’ wherein a certain area of brain, which is the root cause of disease, is marked first and later is burnt through radiation process.” - Dr J N Chaudhary, CEO/founder VIMHANS sector would remain unaffected by it for long. Diseases that were not open to sufferings and were lagging behind since ages have now found new ways through technological and scientific advancements. Against the backdrop of health care reform and a controversial medical device tax, medical technology companies are now focusing more on products that deliver cheaper, safer, faster, and much more efficient patient care without any loss of time, money and efforts. Let’s take a look at some of the biggest and prominent innovations
in healthcare technologies which are in vogue both in India and across the world.
Microchips Modeling Clinical Trials. The potential to streamline, enhance boost and perhaps transform the current healthcare system is gigantic beyond words. That’s how microchip modeling clinical trials came gradually into usage because there was an open opportunity and a need to innovate on the way clinical trials have been done. Microchip modeling clinical trials target to replace the usage of animals in clinical trials to more accurately test the safety and efficacy of treatment for human beings and gradually stop taking the lives of helpless animals generally used in experimenting. These microchips are typically smaller than a human thumb, can reconstruct the complicated interface between organs and capillaries, which is similar to the idea of micro fabrication, the process of making structures on a micrometer scale. By eliminating animal prototypes in certain circumstances, scientists and doctors have been able to reconstruct organs like the human lungs by focusing on the usage of complicated
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This is so important because according to most doctors many don’t survive a medical condition or emergency each year because the right patient needs to be at the right place at the right time and this isn’t often the case as most live in the rural areas. Scientists and doctors across the globe argue that with the continued adoption of wearable technologies like Google Glass, more lives will be saved now in communication since communication between medical professionals and patients will remain on the platform of improvement and take it to higher levels. systems of microchips to emulate these bodily systems. In most cases, animals pass as adequate human stand, but in some cases, they do not come at accurate results on how human beings would be affected by the same procedures, diseases and treatments. Today, microchips more closely resemble live tissue, cell types and realistic threedimensional interactions present in the human body than do other forms of clinical testing presently.
Wearable Technology like Google Glass Wearable technology is still in its infancy, but has already started to have widespread influence across many hospitals and other industries. The very first surgeon to use Google Glass in the surgery or wearable technology in general while performing a surgery was Dr. Rafael Grossmann. As wearable technology continues to improve to better meet the needs of doctors and surgeons, healthcare providers continue to hope that its usage will affect both the health of patients and surgeons to better receive and monitor the patient care system. The pioneer of Google Glass; Dr. Grossmann claims that Google Glass and other similar wearable technology will improve the manner in which healthcare service providers communicate with patients and their family members thereby improving the cus-
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tomer satisfaction of patients. In addition, making doctors quite effective in their jobs due to the better channels of communication with patients. He sees this new technology as great permission for a doctor to someday interact with a patient, while simultaneously pulling up their medical history using Google Glass. The surgery performed using Google Glass could serve as an example of realtime education for medical students and other professionals alike. There are even telemedicine opportunities with Google Glass as well, allowing doctors and other medical experts to provide clinical care in certain capacities from a different location. The practice is already in use by doctor’s providing medical advice via the phone or e-mail in many instances across the United States but, it’s the technology that limits how effective this approach can be when it comes to what level of care is needed to be administered.
3D Printed Biological Materials There have been increasing widespread utility of 3D printers these days, and interestingly the medical uses are also extremely practical and overtime could indeed resolve ongoing health issues once it’s discovered how to precisely apply them to numerous people. Embryonic Stem Cells: These cells have now been efficiently printed in a lab and could be one-day use to create tissue that could help test drugs and help in the development and further growth of any new organ. Printing Skin: Of late, there have been many advances in the areas of developing skin to help burn victims and skin disease patients, 3D printers can help further jumpstart these advances with the addition of laserprinted skin cells. Blood Vessels & Heart Tissue: Organovo is a company that has already successfully printed blood vessels and
sheets of cardiac tissue that actually beat along just like a real heart. Replacing Cartilage & Bone: 3D printers have also helped scientists and doctors create stem cells that have the potential to eventually develop into both bone and cartilage of the body. Studying Cancer: Printing cancer cells is indeed an innovative way of growing these cells on tissue in a lab for further experimentation process, test drugs on and to eventually find a solution for deadly diseases that have haunted since ages. Patching a Broken Heart: Printing cells with a 3D printer proves useful in a recent study of rats that had previously suffered heart attacks and were given these patches of cells to
help slowly help improve their heart function overtime. Replacement Organs: Printing new part for organs or entire organs all together will help solve an ongoing medical need and help saves hundreds of thousands of people every year waiting for an organ donation to help them.
Optogenetics This latest medical technology has
kick started the technique in neuroscience called as optogenetics, where neuroscientists aim a single neuron in the brain of a mouse merely by turning on a light. This is done by using a light activated gene and inserting it into the genome of a mouse to make it identifiable, when the particular neuron is firing in the brain. Optogenetics is a hot topic amongst the medical community today, but it’s surrounded by both advantages and disadvantages as well. Its main purpose is to control a brain’s activity through a light. This could have far reaching benefits with humans to help better understand the complex network of neurons that form the composition of a human brain. A stronger comprehension could
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help humans grasp human behavior, generation of ideas, thoughts and also process of actions and reactions. Identifying these neurons may sometime help people monitor the errors or deformities in the various neurons in the brain that may cause devastating mental disorders like Schizophrenia, Parkinson’s, panic attacks, mood disorders, dementia and severe depression. By controlling the tasks of specific neurons, neuroscientists began to learn how various neutrons contribute to the entire functioning of the human brain. The firing of a neuron through proper lighting may someday be a technique to get answers to some of the several open questions human civilization has always pondered on in terms of both medically and physiologically since the dawn of time or this technique may not be able to work with humans because of its invasive nature in its current applications with tiny animals like rats. As of now, only future holds the answer to whether this approach will prove effective and fruitful. But despite all, the study of human brain using light will help neuroscientists towards a better understanding of the neurons and how they function across the complicated body organ.
Hybrid Operating Rooms With the addition of new technology, comes the integration with established technology and systems that either needs to be replaced totally or be connected with for better improvement of performance or build upon the latest and fresh technologies and their usage. No doubt, this is a herculean task for healthcare professionals due to the complexities present in the systems, technologies and operations currently in place at all healthcare facilities, hence explains why this industry is often the slowest in pace when revolutionary changes become the need of the hour. A hybrid operation room is a latest innovation where a traditional operation room is transformed with highly
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The pioneer of Google Glass is Dr Grossmann who claims that Google Glass and other similar wearable technology will improve the manner in which healthcare service providers communicate with patients and their family members thereby improving the customer satisfaction of patients .Google glass have made doctors quite effective in their jobs due to the enhanced channels of communication with patients now. Doctor sees this new technology as permission for interaction with patients, while simultaneously pulling up their medical history using Google Glass. advanced forms of medical technology to improve the care delivered to patients and enhance the skill-sets of medical practitioners when it comes to monitoring the care of patients. Today, the technologies used in hybrid operating rooms have generally helped reduce trauma, shock, scarring, spurred faster rehabilitation and has aided in reduction of hospital stays and any further admission of patients. The technologies used at the various foreign hospitals that helped improve a patient’s experience at a hospital included advanced imaging technologies that allowed for real-time intra-operative image guidance, as well as tools
to help perform high-risk minimally invasive cardiac procedures.
Digestible Sensors Approved three years ago, digestible sensors will continue to provide healthcare professionals with more information about the human body and how various treatment solutions affect each system of organs. A digestible sensor is actually a sensor that transmits information about a patient to medical experts to help them customize various medical care to the individual as well as the care provided to other individuals who might or might not have similar disease or ailments. This technology would eventually allow an individual to swallow a pill provided by their respective doctors and skip their presence due to these digestible sensors that look like a normal pill and have the capacity to perform all the same functions a doctor typically handles in a personal interaction with a doctor in standard treatments. Digestible sensors are capable of monitoring your bodily systems and wirelessly transmit what’s happening in the body to a different device like your Smartphone, iPad or personal computer for your own review or perhaps examination by the doctor later on. Latest innovations with digestible sensors don’t even require a battery source since they depend totally on the human body for their energy purposes. An innovation of this nature could
have far reaching effects for healthcare by helping in checking diseases and conditions in initial stages in people for digesting these sensors that are in reality examined through a wireless connection. In healthcare innovations there’s an infographic on these developments and others that drastically impact the future of healthcare for patients and professionals alike in terms of future of Indian medical equipment, science and technology.
Cloud-based provider relationship management Needless to say, communication has been one of the biggest hassles faced by healthcare industry today. From numerous referrals, progress updates, and insurance authorizations; these numerous communications channels result in big wastage of money, efforts, time and last but not the least, a liability to every healthcare provider. Primary care providers and specialists require fresh and latest information in real-time, which sometimes a phone call or a fax machine might not be able to fulfill this need. Patients are stuck halfway through as doctors still communicate with antiquated systems delaying the much needed critical care. Studies state that as many as 70 percent of referrals are not received by the specialty care provider. With these numbers soaring so high each day, patients are not receiving treatment, healthcare providers are losing money, and eventually the cost of healthcare to tax payers remain ever increasing. He sees this new technology as allowing a doctor to someday interact with their respective patients, while simultaneously pulling up their medical history through Google Glass. The surgery performed using Google Glass could serve as an example of real-time education for doctors, medical students, scientists and researchers. There are even telemedicine opportunities with Google Glass as well, allowing doctors and other medical
With the most deadly form of skin cancer, melanoma, a huge number of dangerous-looking moles have no impact and are normal in nature, but has always been impossible to understand completely without an invasive surgical biopsy done professionals to provide clinical care in certain capacities from a distant location. The practice is starting to be used by doctor’s providing medical advice on phone, iPad, skype or email in many instances across the globe, but it’s the technology that limits how effective this approach can be when the question of attaining the zenith in patient care process and related administration arises. There is no denying that this is quite critical because according to scientists, many don’t survive a medical condition or emergency each year because the right patient is unable to reach at the right place that too at the right time simply because most people don’t live near a good hospital and are based in rather rural areas with negligible medical facilities. Grossmann has used Apple’s FaceTime to discuss crucial patient
crises as well as virtual examinations with patients in various locations across the country, able to severely impact the outcome of their care. He argues that with the continued adoption of wearable technologies like Google Glass, more lives will be saved since communication between medical professionals and patients will continue to improve to the next level.
Cutting Back on Melanoma Biopsies
With the most deadly form of skin cancer, melanoma, a huge number of dangerous-looking moles have no impact and are normal in nature, but has always been impossible to understand completely without an invasive surgical biopsy done. Today, dermatologists have new help in deciding upon this form of skin cancer, a tool approved by the FDA (food and drug administration) for multispectral analysis of tissue morphology. The MelaFind optical scanner is not for definitive diagnosis, but rather to provide additional information a doctor can use in determining whether or not to order a biopsy. The goal is to minimize the number of patients suffering from unnecessary biopsy marks, with not to forget the extra effort and money and unnecessary medical procedures involved in removing those scars. In America, the MelaFind technology (MELA Sciences, Irvington, NY) uses missile navigation technologies originally paid for the Department of
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Defense to optically scan the surface of a suspicious lesion at 10 electromagnetic wavelengths. The collected signals are then processed using heavy-duty algorithms and matched against a registry of 10,000 digital images of melanoma and skin diseases.
Electronic Aspirin For people who suffer from migraines, cluster headaches, and other causes of chronic, excruciating head or facial pain regularly, the numerous pills like aspirin and disprin methods are actually futile. Researchers and doctors have since long associated the most severe, chronic forms of headache with the sphenopalatine ganglion (SPG), a facial nerve bundle, but haven’t yet discovered a treatment that works on the SPG long-term. A technology under clinical investigation at Autonomic Technologies, Inc., California is a patient-powered tool for blocking SPG signals at the very first signs of a chronic headache. The system includes the permanent implant of a small nerve stimulating device in the upper gum on the side of the head normally affected by headache. The lead tip of the implant connects with the SPG bundle, and when a patient senses the onset of a headache, he or she places a handheld remote controller on the cheek closest to the implant. The resulting signals stimulate the SPG nerves and block the pain-causing neurotransmitters.
Needle-Free Diabetes Care Diabetes self-care is a pain since ages. It brings the constant need to draw blood for glucose testing, the need for daily insulin shots and of course the heightened risk of infection from all that poking and injections. Continuous glucose monitors and insulin pumps are today’s best options for automating most of the complicated daily process of blood sugar management, but they don’t completely remove the need for skin pricks and shots. But there’s new skin in this
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game. Echo Therapeutics in America is developing technologies that would replace the poke with a small patch. The company is working on a transdermal biosensor that reads blood analytes through the skin without drawing blood. The technology involves a handheld electric-toothbrush-like device that removes just enough top-layer skin cells to put the patient’s blood chemistry within signal range of a patch-borne biosensor. The sensor collects one reading per minute and sends the data wirelessly to a remote monitor, triggering audible alarms when levels go out of the patient’s optimal range and tracking glucose levels over time.
Robotic Check-ups A pillar of health reform is improving access to the best health care for more people. Technology is a cost-effective and increasingly potent means to connect clinics in the vast and medically underserved rural regions of India with big city medical centers and their specialists. Telemedicine is well established as a tool for triage and assessment in emergencies, but new medical robots go one step further—they can now patrol hospital hallways on more routine rounds, checking on patients in different rooms and managing their individual charts and vital signs without direct human intervention. The RP-VITA Remote Presence Robot produced jointly by iRobot Corp. and InTouch Health is the first such autonomous navigation remotepresence robot to receive FDA clearance for hospital use. The device is a mobile cart with a two-way video
screen and medical monitoring equipment, programmed to monitor and work in the busy halls of a hospital.
A Valve Job with Heart The Sapien transcatheter aortic valve is a life-saving alternative to open-heart surgery for patients who need new a new valve but can’t endure the rigors of the operation. Manufactured by Edwards Life Sciences (Irvine, CA), the Sapien has been available in Europe for some time but is only now finding its first use in U.S. heart centers, where it is limited only to the frailest patients. The Sapien valve is guided through the femoral artery by catheter from a small incision near the grown or rib cage. The valve material is made of bovine tissue attached to a stainless-steel stent, which is further expanded by inflating a small balloon when correctly placed in the valve space. A simpler procedure that promises dramatically shorter hospitalizations is bound to have a positive effect on the cost of care. Apart from these mentioned medical equipment, there are many more making way and huge success sin Indian health care industry too. Let’s understand what these top ten latest medical technologies in the present year are.
Targeted therapy for cancer Well, there’s new hope for people with chronic lymphocytic leukemia (CLL), a cancer responsible for several deaths per year. After promising clinical trial results, the first-in-class oral drug ibrutinib is expected to be approved by the U.S. Food and Drug Administration for treatment of CLL. The drug targets malignant cells present in the body, while successfully sparing a patient’s immune system.
Heart risk through the gut Last year, researchers and medical experts added a new biomarker to the hunt for heart disease: TMAO. Your body produces TMAO (trimethylamine N-oxide) when your gut bacteria di-
gest choline, which is found mostly in egg yolks, red meat and all milk and dairy products. Choline is thought to promote hardening of the arteries in heart. Besides, TMAO provides an accurate screening tool for predicting future risks and hazards of heart attack, stroke and death.
Personal sedation station Novel, personalized “sedation station” technology allows healthcare professionals other than anesthesiologists to deliver the light sedation required for life-saving colonoscopies. The technology could help bring the nationwide cost of this crucial test down by a good amount every year.
not only records everything that happens before, during and after surgery, it also has an alert system, influenced by technology used in jets; that highlights potential problems in real time.
Breakthrough for hepatitis C Until 2011, there were no proven medicines for patients who didn’t respond to traditional therapy in the outbreak of hepatitis C. But two drugs, telaprevir and boceprevir, made the top ten innovations list two years ago. Now, another — sofosbuvir, the first all-oral therapy — further expands the list of treatment options. The drug promises the highest cure rates ever, reduced treatment time and fewer side effects.
cision medicine. These tests analyze the genes in an individual’s tumor and body to predict and analyze as to how it would respond. Past tests have improved management of breast and colorectal cancers, and last year, the FDA approved a similar test for prostate cancer too. The goal of these tests is to avoid any hard and aggressive treatment when it is not actually needed, and hence save lives and offer ease to the suffering patients.
Bionic eye The bionic eye has become a reality now, in the past, there was no effective treatment for late-stage retinitis pigmentosa (RP), a disease that causes most pa-
Hope for acute heart failure As per WHO, heart failures account for approximately 55,000 deaths every year. There had not been a major treatment breakthrough in two decades, until the arrival of serelaxin. This synthetic version of a human hormone gained “breakthrough” status from the FDA last year. Serelaxin study results reported a 38 percent reduction in death rates after six months in patients with acute heart failure, compared with those who received standard therapy.
Fecal transplant restores balance In fecal microbiota transplantation, doctors transfer a liquid suspension made from a healthy person’s fecal matter into a sick person’s colon. Basically, the goal is to restore bacterial balance and fight infections and diseases. This approach could become a primary therapy not only for treating deadly and fatal infection, but also for inflammatory bowel disease.
Decision support for smarter surgery A new anesthesia management system helps surgeons, anesthesiologists, nurses and others make smarter decisions in the operating room. The system
Device disrupts seizures The seizures that come with epilepsy disrupt life — but a new neurological device can disrupt seizures. For patients with intractable epilepsy, in which treatment fails to control seizures, the experimental technology is especially promising. The surgically implanted device can detect triggers of an impending seizure and deliver short electrical pulses to interrupt them before any possible symptoms occur.
Genomic tests for managing cancer Genomic-based tests have brought a new age of cancer diagnosis and pre-
tients to be legally blind by the time they attain 40 years of age. A new technology featuring a retinal prosthesis; commonly called the “bionic eye” has transformed everything. This technology does not restore complete vision. But it does allow people to detect light and dark in the environment and identify the location or movement of people and objects. Despite major advancements in medicine and its technology, surgical procedures are still associated with complications such as infections and sepsis. Lack of antiseptic measures and unsafe instrument sterilization practices often lead to surgically-induced infections.
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company Profile I
Nihon Kohden India Private Limited Company Details Managing Director: Hirotsune Kobayashi Team • Medical Equipment - Anil Srivastava - National Sales Manager • IVD - Nitin Srivastava - National Sales Manager • Customer Support - Girija Pathak - Manager, Customer Support Year of Inception: 2011 | Employee Strength: 85 Head Office Address: 308, Tower A, Spazedge, Sector 47, Sohna Road, Gurgaon-122002, Haryana Telephone :+91-124-493-1000, Fax: +91-124-493-1029 Toll Free Customer Care No: 1800-103-8182 Email: info_nki@nihonkohden.co.jp
Hirotsune Kobayashi
Website: www.nihonkohden.com
Company Profile Nihon Kohden Corporation is Japan’s leading manufacture, developer and distributor of medical electronic equipment with subsidiaries in the USA, Europe and Asia and distributors in nearly every country in the world. Founded in 1951, our mission is to improve the quality of life through advanced medical technology. Pulse Oximetry, technology to measure oxygen in the blood, was invented by Dr Takuo Aoyagi, a Nihon Kohden Scientist. Nihon Kohden has introduced many innovative technologies, which are very advantageous for faster diagnosis & easy usage. For example, 18 lead ECG is very useful in detecting right side and posterior infarction, esCCO noninvasive continuous cardiac output, Hemodynamic graph for sepsis stroke patients, World’s first wearable, mainstream CO2 sensor for non-intubated patients and many more. Nihon Kohden India Pvt. Ltd. is a 100% owned subsidiary of Nihon Kohden Corporation located in Gurgaon, Delhi-NCR. In a short period of just 39 month’s operation, we have got fantastic business from all segments of customers including many prestigious hospitals like AIIMS, PGIMER, SCTIMST, JIPMER, Apollo Healthcare, Fortis Healthcare, Manipal Healthcare, Max Healthcare, Ruby Hall Clinic, MIOT Hospitals, KIMS Healthcare, to name just a few. Nihon Kohden products are now in the Green channel list of Fortis Healthcare hospitals within 3 years of direct operations in India.
Frost & Sullivan has chosen Nihon Kohden as • ‘Asia Pacific Patient Monitoring Company of The Year 2012’ • ‘Innovation in Medical Technologies Company of the Year -2014’ at Frost & Sullivan’s 6th Annual India Healthcare Excellence Awards 2014
Products and Services • • • •
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Multiparameter Patient monitors Central Nursing stations Wireless Telemetry esCCO : Noninvasive continuous Cardiac Output
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• • • • • • • • •
Biphasic Defibrillators ECG machines ( 3, 6, 12, 18 channel) AED (Automated External Defibrillators) EEG Systems (Up to 256 Channels) EMG / Evoked Potential/NCS System EEG (Amplitude Integrated EEG) Epilepsy Monitoring Unit (EMU) Intraoperative monitoring 3 part, 5 part & Veterinary Automated Hematology Analyzer
company Profile I
PALASH Healthcare Systems Pvt Ltd Company Details Managing Director and CEO: Dinesh V Samudra Management Team: Prasad Kulkarni ( Head technology and Domain Expert), Nilesh Ingale ( Head R & D projects), Swapnil Joshi(Head – International Business Development) Year of Inception: 2006, Number of Employees: 120 Head Office Address: Gopal House, 3rd Floor, Karve Road, Kothrud 411029 Telephone: 020-6624161 E-mail: info@palashhealthcare.com, Website: www.palashhealthcare.com Sales Customer Support: Swapnil Joshi- +91 8850177456/ +91 7276074004 and Bhushan Deshpande- +91 9823030025 Contact Person: Archana D Samudra archanas@palashhealthcare.com; +91 9823926028
Dinesh V Samudra Company Profile
PALASHTM Healthcare Systems (PHS) was incorporated in 2006 by team of Information Technology experts having more than 15 years of experience then in providing Software Solutions and Information Technology Consulting to various domains. The early days were entirely focused on acquiring domain expertise in healthcare provider market for building applications focused on resolving core pain areas in managing patient records, inventories and core Management Information Systems. The professional experience in healthcare is a particular advantage as solutions are developed from the perspective of the user, whether it be a pharmacist, a nurse, a doctor, hospital manager or an IT specialist. PHS on its proprietary Health Information Management Platform, PALASH offers software solutions to various verticals of Healthcare Provider segments viz. Multispecialty Hospitals, Specialty Clinics such as IVF, Ophthalmology, Nephrocare, Cardiac Care , Day Care, Dental and Diabetes along with solutions for diagnostic centers. Recently PHS has forayed in to Government Sector with readiness of solution for delivery to Hospitals, Primary & Secondary Health Centers and District Health Centers. PHS also has regional offices in Mumbai and New Delhi along with regional support offices in Kolkata, Bhubaneswar and Bangalore through its business partners.
Products and Services
Top 5 Clients in India
EMR on PHS platform: Diabetic, Ophthalmology, IVF, Oncology, Nephrology, Cardiology, Urology, Diagnostics Orthopaedics etc
• Dr DY Patil Hospital & Research Centre • Inlaks and Budhrani Hospital • Sunshine Hospitals • Mewar Group of Hospitals • Inamdar Multi-Speciality Hospital
Business Collaboration Accenture is a global management consulting, technology services and outsourcing company, with more than 305,000 people serving clients in more than 120 countries. Combining unparalUSP leled experience. PHS is a specialized healthcare
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IT organisation offering software services and cutting-edge solutions to healthcare providers
Turnover • 2011 – 2012 (Cr.): 3 Cr • 2011 – 2012 (Cr) 4Cr. • 2012 – 2013 (Cr.) 6 Cr.
Innovation and Excellence in Healthcare IT
TM
“PALASH Healthcare Systems (PHS) is specialized Healthcare Information Technology organization offering various software services and solutions to healthcare providers.” •
More than 200 installations in the Healthcare space
•
Managing more than 5 million patient records
•
More than 127 Hospitals use PALASH HIS Solutions
•
Strong presence in India as well as overseas
•
Around 71 Pathology labs using our solutions
•
Ayurveda Clinic chains as customers
•
Offices in Dubai, Jordon and UK
PALASH Healthcare Systems Pvt. Ltd.
S.No.127, 3rd Floor, Gopal House, Karve road, Kothrud, Pune 411 029, INDIA. Tel: + 91 20 66246161, Fax: +91 20 65261436 Email: info@palashhealthcare.com Website : www.palashhealthcare.com ; www.palashpractice.com
palash
practice
company Profile I
AGFA Healthcare India Pvt Ltd Company Details Managing Director: Suresh Ranganathan Management Team: Prasad Paranjpe, Pravin Kaprani Head Office Address: Agfa Healthcare India Pvt. Ltd, Technosoft Knowledge Gateway, B-14, Road No,1, Wagle Industrial Estate, Thane (West)-400604 Maharashtra, India. Telephone: +91-22-40642900 E-mail: sales.india@agfa.com Website: www.agfahealthcare.com Sales and after sales Support: sales.india@agfa.com Contact Person: Samith K K, +91 22 40642924 samith.kk@agfa.com
Suresh Ranganathan Company Profile Agfa HealthCare, a member of the Agfa-Gevaert Group, is a leading global provider of diagnostic imaging and healthcare IT solutions and has been a pioneer on the healthcare IT market since the early 1990’s. We offers our customers an extensive portfolio of solutions, including radiology information systems (RIS), picture archiving and communications systems (PACS), cardiology information and image management systems, solutions for reporting, enterprise scheduling, decision support, and data storage as well as digital radiography, computed radiography, print solutions, film, and associated products. IT solutions developed and implemented by Agfa Healthcare work across departmental disciplines to integrate information and streamline the workflows and operations of hospitals, imaging centers, and other healthcare facilities, enabling a more effective and efficient healthcare offering. Imaging systems developed and implemented by us capture, process, and manage diagnostic images from a multitude of sources within and beyond the healthcare enterprise, integrating these into a variety of workflows and systems. These systems are designed to bring vital information to medical practitioners regardless of their location.
Top 5 Clients in India
Products and Services • Computerized radiography systems: CR 10-X, CR 12X,CR 15-X, CR 30Xm, ( single Plate CR systems) DXM,DXG ( Multiplate CR systems) • DR systems: DX-D 800 (High end robotic Digital radio fluoroscopy system), DX-D 600 (Ceiling Suspended DR system), DX-D 400 (Floor mounted DR systems), DX-D 300 (Fully automatic U arm DR system), DX-D 100 (High end Mobile DR systems), DX-D Retrofit (A range DR retrofit panels) • Hardcopy Solutions: Drystar 5503, Drystar Axys, Drystar USP 5302, Drystar 5300 With an in-depth experience
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and understanding of imaging solutions, we offer a unique blend of products
• West Bengal Medical Services Corporation (29 DR systems) • Punjab Health systems Corporation (23 Multiplate CR systems)
Turnover 2012 – 2013 (Cr.): 1.16 Billion Euro (Global).
Around the world, radiology
TRUSTS IMPAX
With more than 2700 installations in over 100 countries, radiology departments around the world rely on IMPAX. Built on 20 years of experience and proven best practices, this complete digital image and information management solution offers you the tools you need for a fast and efficient radiology workflow. From scheduling to image management and productivity tools, trust IMPAX 6 to support you end to end. Agfa HealthCare India Pvt. Ltd. Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West)- 400 604 Email for enquiries: sales.india@agfa.com Mumbai 022-40642900
New Delhi 011-41510858
Kolkata 033-22820745
Chennai 044-42125263
Insight. Delivered.
Learn about Agfa HealthCare at www.agfahealthcare.com
company Profile I
Transasia Bio-Medicals Limited Company Details Managing Director: Mr Suresh Vazirani Management Team: Mrs Mala Vazirani, Executive Director Year of Inception: 1979 Head Office Address: Transasia Bio-Medicals Ltd. Transasia House, 8 Chandivali Studio Road, Andheri(E), Mumbai – 400072 Telephone: +91-22-4030-9000 Website: www.transasia.co.in
Company Profile Established in 1979, as a small marketing firm for few imported diagnostic equipments, Transasia BioMedicals Ltd. today, is India’s Largest In-vitro Diagnostic Company. Headquartered in Mumbai, it offers an entire gamut of products and services across the sectors- Biochemistry, Hematology, Coagulation, ESR, Immunology, Urinalysis, Critical Care, Electrophoresis, Molecular Diagnostics, Diabetes Management and Microbiology. This dream of Mr. Suresh Vazirani, Chairman & Managing Director, has grown into a global reality. Transasia Bio-Medicals Ltd has fortified its presence, being recognized as India’s top manufacturer and exporter of diagnostic instruments and reagents in over 100 countries. Infact, Transasia is the first Indian company to manufacture and export sophisticated, state of the art blood analyzers and reagents. Transasia has over 45,000 installations across the country with a vast network of more than 150 service engineers, 350+ Sales and Marketing Team, 14 zonal offices, and 300+ Distributors, daily living upto its motto of providing ‘customer service of the highest quality.’ Its foray into indigenous research, at its manufacturing facilities in Daman (Gujarat), Baddi (Himachal Pradesh), Seepz (Mumbai) and Mannheim (Germany) has resulted in development of state of the art products and technologies, enabling Transasia’s deliverables to be synonymous with the best in the world. All along its journey, spanning over three decades, the organization has gained reputation and immense respect from its trusted partners worldwide.
Business Collaboration ATransasia has strategic alliances with some leading names in the diagnostic world like Sysmex Corporation (Japan), Medica (USA), Diesse (Italy), Immco Diagnostics (USA), Helena (Europe) and Gen-Probe (USA). Medical Technology: Respiratory Devices
Top 5 Clients in India • Dr DY Patil Hospital & Research Centre • Inlaks and Budhrani
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USP
With a vision of being recognized as a ‘local for global’ organization, Transasia continues to provide doctors and patients with reliable, affordable and innovative Medical Diagnostic Systems
Hospital • Sunshine Hospitals • Mewar Group of Hospitals • Inamdar Multi-Speciality Hospital
Turnover • 2011 – 2012 (Cr.): 3 Cr • 2011 – 2012 (Cr) 4Cr. • 2012 – 2013 (Cr.) 6 Cr.
company Profile I
Komega Impex Company Details Address: Komega Impex Regus, Trade Centre level 1, BKC, Bandra (E), Mumbai - 400 051, Maharashtra, India. Telephone: +91-22-61623843 Fax: +91-22-61623800 Mobile: +91-9967643131 Email: komegaimpex@gmail.com Website: http://www.komegaimpex.com
Company Profile Komega Impex is into the Medical Equipments market, and are selling a variety of New and Pre-owned radiology equipments like Ct scan, MRI like Hitachi (permanent magnet) MRI MRP7000, AirisI, AirisII, and CT Scanner likeToshiba 64 slice CT Scanner, 16 Slice CT Scanner, 4 Slice CT Scanner and Cathlab Ge Flat Panel Innova and CCD cathlab, Dialysis Equipment - Fresenius and New equipment like Gastroenterology (ERCP) and Cardiology, brand new of Omega Medical Imaging, USA for India. We also market Omega Cath lab of USA SINGLE PLANE CORONARY ANGIOGRAPHY/DSA COMBINATION. We also market E-view (ERCP) of USA for Gastroenterology dept. forimage guided an endoscopic and GI procedure which produces “best in class performance”. The system includes, a 5 way motorized patient table, imaging system, image processor and image display. We KOMEGA IMPEXhave privilege to inform you that we are offering Joint Venture for Cardiac Cath Lab, MRI, CT scan etc., depending on the volume of the business. We are the one company who got every time repeat order from our all existing customer because of quality system, on time completion of the project and service. We also do joint venture for Cardiac cathlab and MRI with hospitals and diagnostic centre. Already our Joint Venture of Cath Lab, MRI is running successfully and Hospital get benefited with more patients in ICU as well more affiliation with Government and Corporate. Be assured about our after sales service as we are ready to participate in Investment also. If you are interested for joint venture/purchase, please feel free to contact us.
Top 5 Clients in India
Products and Services • • • • • •
System Cleaning Optical Reconditioning CT X-Ray Tubes Siemens Mammography Digital Bone Densitometry DKS1710 Wet Digital Labs
Business Collaboration • Siemens • Hitachi • Naomi
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USP We are the only supplier who do investment with hospital and diagnostic centre to buy the equipment which further help them to buy equipment and give confidence of getting the good service from the suppliers
• Ozone hospital, Akola • Anand Surgical hospital, AHMEDABAD • Sagwan hospital, Sirsa • Shri Balaji Inst. of Med.Science Pvt. Ltd., Raipur • Sapra Hospital, Hisar, • Sahyog Hospital, Guna
A Reliable and Reputed Supplier of Pre-Owned Medical Equipments
Komega impex is in Medical Equipments Market and are selling a variety of New and Preowned Equipments like Cath Lab Angiography System, MRI, CT Scanner and Dialysis Equipments.
! " # ď ľ GE - Flat Panel Cath Lab Angiography System ď ľ Siemens - Coroskop T.O.P. Cath Lab Angiography
System ď ľ MRI System - Hitachi : Airis-I and Airis-II ď ľ CT Scanner - Toshiba ď ľ 64 / 16 / 4 Slice CT Scanner
Can you get a flat panel Cath lab with one year warranty for 60 lacs*
Regus, Trade Centre Level 1, BKC, Bandra (E), Mumbai - 400 051 Maharashtra India Tel. : +91-22 61623843 | Fax : +91-22 61623800 Mob. : +91-9967643131 Email : komegaimpex@gmail.com • Website : www.komegaimpex.com *Conditions apply
company Profile I
Maquet Medical India Pvt Ltd Company Details Managing Director: Ashim Purohit Year of Inception: 2004 Employee Strength: 140 Head Office Address: II Floor, Mehta Trade Centre, Sir M V Road, Andheri (E), Mumbai – 400099, Maharashtra Telephone: +91-22-40692100 Email: info.india@maquet.com Website: www.maquet.com Customer Support Helpline number: +91-1800222377, 09821627838
Company Profile The Maquet name has been synonymous with innovation, quality and trust since it was founded in 1838. The company is also a world-leading provider of medical systems that meet the highest requirements for medically challenging interventions. At the same time, these systems exceed the expectations of the hospital teams that are responsible for the care of patients. Maquet designs, develops and sells innovative treatment solutions and infrastructure functions for extremely demanding hospital departments, including operating rooms, hybrid operating rooms, catheter laboratories and intensive care units as well as intra- and inter-hospital patient transportation. With its headquarters in Rastatt, Germany, Maquet is the largest subsidiary of the Getinge Group, which is listed on the stock exchange. With over € 1.54 billion in 2013, Maquet exceeded half of the € 2.92 billion annual turnover of the group. Maquet employs more than 6,550 members of staff at 40 international sales and service organizations and maintains a network of about 300 sales partners.
Products and Services • Operating Room: A large product portfolio enables multidisciplinary OR infrastructure solutions for more efficient clinical workflow. • Critical Care Unit: User-friendly, reliable and portable CCU solutions help you achieve cost-efficient and sustainable patient outcomes. • Hybrid OR: MAQUET partners with hospitals to provide interdisciplinary Hybrid OR that efficiently improve patient care.
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USP Only company to provide one stop solution for OR
• Patient Transport: Life-sustaining ICU-quality technology solutions make inter and intra hospital transport safe and efficient. • Hospital Solutions & Projects: Concepts for optimized processes in OR and ICU environment.
Hybrid Operating Room Prepared for the future
Medical solutions for the Hybrid OR from one source Key customer benefit is the multidisciplinary use of the Hybrid OR – which means it will be usable both for angiographic imaging and for open procedures. Maquet offers in cooperation with leading imaging companies complete OR solutions including the modular room concept VARIOP, OR tables, OR lights, ceiling supply units and leading edge TEGRIS OR Integration. More over, Maquet expands therapy options through offering products in the field of cardiovascular intervention, critical care, and anesthesia. A wide variety of procedures in cardiovascular surgery, traumatology, orthopedics and neurosurgery can be carried out in a Hybrid OR. Equipped with the MAGNUS floating carbon table top from Maquet, an integrated Hybrid OR solution offers additional cathlab functionality, especially useful for cardiac and vascular interventions. Maquet | The Gold Standard
Maquet Medical India Pvt. Ltd. | II & III Floor, “Mehta Trade Centre” No.1, Shivaji Colony, Sir M V Road, Andheri (East), Mumbai – 400 099, India Phone: +91 22 40692100, Fax: +91 22 40692150, info.india@maquet.com
www.maquet.com
company Profile I
MRK Healthcare Pvt Ltd & Nulife Global Medical Devices Pvt Ltd Company Details Managing Director: Rajni Shah Year of Inception: 1965 Management Team: Mahesh Shah – Director - Finance & Production, Kamlesh Shah- Director – Marketing, Yogesh Shah- Director - R&D & Production, Sneh- Director- Strategic & Business Development Head Office Address: B6, Byculla Service Industries, D.K. Marg, Byculla (E), Mumbai 400027. India Telephone: +91-22-23748371-72-73 E-mail: info@mrkhealthcare.com Website: www.mrkhealthcare.com Sales and after sales Support: Sales- sales@mrkhealthcare.com After Sales- order@mrkhealthcare.com +91-22-32488484
Rajni Shah
Contact Person for Clarification: Anita Salaskar, support@mrkhealthcare.com, +91-22-66578913
Company Profile MRK Healthcare began operations in 1965 under the leadership of Mr.Ramniklal Shah for the manufacture and trading of molded rubber industrial products and surgical rubber gloves. “NULIFE” is the Trade Name under which medical products manufactured by MRK. HEALTHCARE is marketed. MRK Healthcare Pvt. Ltd. is one of the India’s leading manufacturers of Medical Disposable and having diversified to Hospital Equipment in the name of Nulife Global Medical Devices Pvt. Ltd. having reputed market presence. MRK Healthcare Pvt. Ltd. is sincerely committed to the care and improvement of human life through continuum of high-quality, cost-effective healthcare products. It has five manufacturing units located in western India, with a total built-up area of 125,000 sq. feet and a further provision for expansion up to 1,200,000 sq. feet. Its Administrative office is located strategically in Mumbai. At MRK we endeavor to provide healthcare more affordable, accessible and qualitative. Our goal is to serve every mother and child, old and young with high quality affordable medical products. Our aim is to provide medical products to healthcare workers who work with passion and compassion to give comfort and healthcare to patient. Apart from the business perspective MRK is equally valued in Philanthropic Projects. A project dedicated to the protection of ageing animals.
Products and Services • Latex Products: Various types of gloves ranging from Exam Gloves, Surgical Gloves to Specaility Gloves Range & Foley Balloon Catheters. • Electro Medical Devices: 4 models of Nebulizers, Needle Burner & Syringe Destroyer-60 Watt &100 Watt, B P Monitor, Air Bed & Weighing Scale • Plastic Disposables: These comprise of IV Sets, B T Sets, Urine bag etc MRK HEALTHCARE Pvt is USP expanding its product
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MRK’s strength is delivering contemporary world class products at competitive prices
range with help of leading OEM manufacturing facility in India & abroad.
Top 5 Clients in India • • • • •
Hinduja Hospital Jaslok Hospital Saifee Hospital Tata Memorial Hospital Bombay Hospital
company Profile I
Hospaccx Healthcare Business Consulting Pvt Ltd Company Details Managing Director & CEO: Tarun Katiyar Management Team: Hemant Khavle - Senior Consultant; Prakarti Shrivastava - Head West Zone; Snakalp Nagar, Head - Operations Year of Inception: 2009 Employees Strength: 22 Head Office Address: 505, Arcadia, Hiranandani Estates, G. B. Road, Thane (W) 400607 Telephone: +91-22-41232233 E-mail: info@hospaccx.in Website: www.hospaccx.in Sales and after sales Support: 022-41232233 Contact Person for Clarification: Prakrati Shrivastava, 9029007981, prakrati.s@hospaccx.in
Tarun Katiyar Company Profile
We have a strong base in India and our projects are spread across various regions. We have completed a number of project reports for hospitals/Medical colleges/Diagnostic centers/Clinics etc in India and abroad. Hospaccx provides entire range of services that any healthcare service provider may require through the large numbers of specialists & associates imparting practical insights to make projects viable. The scope of work provided by 3 arms of Hospaccx includes • Hospital Consultancy which includes market & financial feasibility study in primary & secondary catchment areas, hospital planning & architecture, financial assistance in the form of JVs/ equity, equipment planning & procurement, commissioning assistance, hospital marketing management, hospital renovation & remodelling, accreditation • Hospital furniture & accessories • Hospital Information System
Products and Services • • • • •
Hospital Architectural Consultancy Market & Financial Consultancy of Hospital Operation & Management of Hospital Hospital Health Check up Projects Human Resource Consultancy in Hospital
• • • • •
Kshetrapal Eye Hospital, Ajmer Sanjeevani Hospital, Bangalore Sun Pharmaceuticals Ltd Cadila Healthcare Ltd Aurobindo Pharmaceuticals Ltd
Turnover
Top 5 clients in India
• 2010 – 2011 (Cr.) 17, 21,917 • 2011 – 2012 (Cr) 40, 58,667 • Medipulse Hospital, Jodhpur USP • 2012 – 2013 (Cr.) 60, 00, 000 • Jaslok Hospital, Mumbai We are fastest growing • Vasudev Hospitals Pvt healthcare consultancy company Ltd, Bijapur
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in India. In a short span of time we have built more than 90 hospitals in India and abroad
news
India to get first ever mental health policy
M
ental illness in India has grown so much that the government has promised to frame its first national policy on the issue, said Health Minister Harsh Vardhan on Tuesday. “Unfortunately, society still stigmatizes those who suffer from routine psychiatric problems and so their treatment is either delayed or denied. We need to build up a social movement to change mindsets and focus on the human dimension of mental illnesses,” said Dr. Vardhan in a statement. The new policy will be launched on Oct. 10, the date that will henceforth be observed as National Mental Health Day across India each year. The policy is likely to include provisions for more institutions and trained professionals to tackle mental health. India’s universal health insurance program – another of the health minister’s promises — “will also have a focus on mental health,” said Dr. Vardhan in a statement. “India’s new national mental health policy is a landmark achievement for the Ministry of Health and it is grounded in the principles of equity and justice,” said Vikram Patel, a psychiatrist and professor at the London School of Hygiene and Tropical Medicine, who was part of the committee that submitted a draft of the policy to the health ministry in September. India for decades has largely ignored mental illness. The government spends 0.06% of its health budget on mental health, according to the World Health Organization’s Mental Health Atlas of 2011.
IFC eyes strong opportunities in India’s health care sector
W
hile much of its investment portfolio to-date are with major integrative health service delivery groups, and in pharmaceuticals and life sciences, the International Finance Corporation (IFC) has said it had moved into investing in other verticals like diagnostics and single-specialty care, and has a strong investment pipeline, said Matthew Eliot, Principal Investment Officer, Health & Education, South Asia, IFC. The investment firm from the World Bank group has an investment portfolio in the Indian health care sector with commitments of over $450 million, representing over 30 per cent of its global health care investment portfolio.
Govt bracing up to popularize traditional medicines: Minister
I
ndia’s ancient medicinal systems are being given a ‘newlook image’ as part of the new government’s effort to popularise them without losing their essence, Union Tribal Affairs Minister Jual Oram said today. Such a concerted exercise will specially benefit rural India where people largely rely on local herbal doctors, he said while inaugurating a two-day Traditional Healers Meet in the national capital as part of the Sixth World Ayurveda Congress (WAC). “Deliberations are on with experts and practitioners ensure that such a plan benefits the country’s huge number of villages,” Mr Oram told a gathering of healers, who called upon the government to give accreditation to deserving traditional healers. The minister, while interacting with the Pragati Maidan gathering that had 100-plus healers.
SRL’s study on Vitamin D Day declares younger women and men at higher deficiency risk
M
ales in the age groups of 31-45 & 46-60 (professionals) and women in the age group of 16-30 (adolescent girls and women of child bearing age) are more at risk. Hectic and erratic lifestyle, extreme working hours and limited outdoor
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activities, has resulted in an alarming increase in the risk of Vitamin D deficiency amongst Indians. Remember the age-old axiom our
parents and teachers brain-fed to us even before we developed our cognitive skills? That’s right. An apple a day, keeps the doctor away. Thanks to our indoordriven lifestyles, the time has arrived for us to teach our children a new phrase: ‘Sunshine each day keeps the doctor at
bay!’ SRL Diagnostics a leading healthcare diagnostics player in India, in its recent study on Vitamin D deficiency, conducted an extensive analysis of Vitamin D reports from 37,010 people from four zones across tropical India, only to discover that Vitamin D deficiency.
From Government’s Desk... november / 2014 ehealth.eletsonline.com
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health IT
Dr Jagdish Prasad, Director General of Health Services, Union Ministry of Health & Family Welfare, in an interview with K S Narayanan of ENN, calls for removal of bureaucratic hurdles, sound technical advisors, better coordination among central ministries and timely implementation by states for the success of ‘Digital India’ programme
Ending Red-Tapism need of Hour Prime Minister had announced ambitious Digital India plan. What is in it for the health care system? There are five to six components, namely, e-public health system, hospital information and management system, patient management system, supply chain management system, tele-education system for medical education to share content and resources. The government has already planned the concept of ‘Digital India’ at the national and state level, which will soon be implemented.
What are the challenges involved in implementation of Digital India? Challenges are three-fold; availability of funds; adequate and qualified manpower; and infrastructure issues like Internet and broadband connectivity. Prime Minister Narendra Modi has focused his attention on Swach Bharat Abhiyan. However, if we have to take up the situation of toilets, then it is impossible to have clean toilets without clean water supply. Clean drinking water is essential to prevent water-borne diseases. India has to follow the example of Singapore where residents are provided clean drinking water directly from taps. There has to be coordination between all ministries for holistic development. The government has to focus on preventive management as well. Take for instance implementation of stringent law in road accident cases that prohibits driving without helmets in big or small city. Similarly, we have suggested yoga should be a part of the school curriculum like any other
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There has to be coordination among all ministries for holistic development. The government has to focus on preventive management as well subject. We have consulted the Union Human Resource Development Ministry and it will be implemented from next academic session across India.
How well are various departments coordinating? Different departments should coordinate but unfortunately it is not happening. There should be a chairman above these ministries to take a call on the accountability of funds, functions and functionaries.
As DGHS what is the overall perspective you get about healthcare in India? A lot of improvements are required, starting from improvement in the medical education as it is not well regulated; With
health as a state subject, we have spent a lot of money over the last nine years under National Rural Health Mission, many states lack basic infrastructures. As a result, we are not able to provide primary and secondary health care. Noncommunicable diseases like diabetes and hypertension is on rise besides cancer. This requires tremendous attentionpreventive, curative and rehabilitation. Although many communicable diseases like leprosy, Kala Azar, has come down but now Ebola has emerged as the global health emergency. Now, India has to be adequately prepared for these medical problems. Next comes the basic need of people. Health is subject of many holistic things - mental, physical and social well being. For that we have to work in a coordinated way. However in primary health care, doctors are not available.
What is the way forward then? We can use the six lakh ayurvedic and naturopathy doctors. We should allow these doctors to use common basic medicines. However, it is being objected by the Supreme Court. For this I have written to the government to remove the bar on the ayurvedic doctors. Our purpose is that a doctor with the knowledge of human body is available at the primary health centre.
How else we can transform health system in the country? Targets have to be fixed and riders have to be put in place against the funds if states don’t develop the sector they cannot expect future development aid.
3
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health IT
Kerala has the advantage of better human resources in numbers and skills in comparison to other states, and we continue to lead in healthcare sector too, says Dr K Ellangovan, Health Secretary, Kerala. Karthik Sharma and Nayana Singh take a closer look at the health sector in the state
Health Sector
Gets IT Push
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Kerala has been at the forefront as far as health standard of people are concerned. Please give an overview of operations of health department in the state? Health department in Kerala has structure to similar to other states. It has eight HOD. We have very responsive workforce coupled with demanding patients. The Kerala has a high morbidity rate but a lower mortality rate paradox. Health system has to meet its challenge only by being effective and efficient. And we also have the advantage of better human resources in numbers and skills in comparison to other states. The department as a whole in structure is similar to other states. However, on account of human resource and virtue of people seeking high level of health care, the department is doing very well.
eHealth is first of its kind initiative in the country which has its origin in Kerala. So, please tell us something about it and how far it has been successful? eHealth is a very ambitious project that is appropriately approved and sanctioned by the ministry of information technology. We have done fairly a detailed job in terms of documentation
of our needs. Our request for proposal document is quite comprehensive. Essentially, it has got two parts EHR (Electronic Health Record) and EMR (Electronic Medical Record). The EHR is population based record and EMR is episodic based record. We have get into a mechanism by which ministry of health and family welfare requirement are also taken into consideration. So stipulated by the ministry of health and family welfare EGR and EMR has been built in our system. We have tendered out a RFP and selected a vendor or a client or a service provider. Work has just begun for it. It has two parts. The first tender
is on software part this is to deliver a business process cycle in hospitals and after that go for hardware tender to equip the institutes with computers, tablets and note pads. Idea is to capture the entire transaction between physician and a patient in on electronic format. So that data is ready not only for research, policy formulation but also patient management. This begins with appointment of patients and doctors, post treatment followup and survey. Entire episode will be captured into electronic format. In two three months, we will finalize the software, customize it and finalize it and in next six months it will be im-
plemented on pilot basis in districts of Thiruvananthapuram.
For such an ambitious project are you planning to carry it on PPP mode to carry it out? How are you planning to execute it out? No, we have selected a service provider; we have tendered it out on the lowest bid. We have formulated committees and project management team that interact with service provider on day-today basis. In this way data information is shared across on both sides and concept is developed to work further. There is no PPP and third party.
Public health care in the Kerala is one of the highest in India as cited by various indices and studies? Tell us about its success? Public health care is quite successful here in Kerala by push and pull factors. We have a policy of decentralized planning. In terms of Public Health Care at the lowest levels decisions are made at Panchayt ward level committees headed by ward member named as ward level sanitation committees. So every year, this committee is given money by Gram Panchayats, Government and NGRM. Gram Sabhas having money with them at ward levels identify public health
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health IT
to women health the strength is seen in public health by excellent performance in reduction of EMR and IMR. That is because of the awareness of people. There are three mandatory anti natal check ups for possibly highest in the country in Kerala. This way maternal health is taken care off in the state. We also have vibrant public health nurses JPHS and supplement field health care workers known as Ashas. Ashas are educated young enterprise health care workers.
Along with being an IAS officer you are also a Medicine Doctor, where do you see Kerala in terms of health care in coming times?
threat. They do awareness things with Panchayats. At the lowest level the public health is discussed and from there the information is goes up to Panchayts, Blocks and District Panchyats yayet. So, the health care in Kerala is decentralized to the ward level.
As far as rural health care in Kerala is concerned, How do look at rural health in Kerala? Kerala basically is a rural urban continual, you don’t really demarcate and urban and rural area here. But we have such pockets as tribal and costal blocks. We depends heavily on the field staff department, JPHS to public health nurses, lady health inspectors and blocks PHCS. Data from these areas communicable diseases is shared. Integrated Surveillance of Disease ISDP projects are being carried out. We have well connected web based system. System of close monitoring and reporting of communicable diseases instances work here.
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As you said Kerala is RuralUrban continual, It is one of the most urbanized areas in India, What steps are you taking to assure public health in urban areas? We have a good share of Urban Health Mission. In fact corporations are responsible for health care in urban areas. But we have introduced urban health centers. We find many of people coming to these centers. Urban Health Mission, that was earlier separate from NHRM last year now has integrated and has become NHM mission. NHM now caters to urban as well as urban health component.
Please throw light on your views how you are planning at policy level to ensure health standards for women and children, especially? We have strong system of women role in decision making in Kerala. With respect
In the area of health care, Kerala has strong fundamentals in terms of terms of institutional support and the people in the state have high health seeking behavior. The health is an important area in Kerala because people have attached lots of importance to health consciousness. They don’t neglect their own health. And government is also extremely active about the health of masses, therefore have spent a good amount of money on health during four years. There has been an increase of 58% in 58% in plan outlay. An amount of 445 crores was incurred on health during 2010-11 and that rose to 665 crores in 2013-14, with an increase of 15 to 16 percent every year. That is considerably 7 to 8 percent annually for other states of India in comparison. With this type of plan outlay, you will be able to increase the number of staff. We have added almost 3,000 staff in Kerala health department in last three years. We through NHRM supplemented in personal and difficult areas. I think, Kerala is doing well in health care sector. The challenge is not communicable diseases but communicable diseases. We are concentrating special focus on controlling and managing diabetes, hyper tension and lifestyle disorder and diseases for Kerala in coming times.
health IT
IT Smoothens Health Services
IT can do things for the health department that haven’t been done or imagined before, says Sujata Saunik, Principal Secretary, Public Health Department, Government of Maharashtra, in an interaction with Elets News Network (ENN) How do you visualise changes in your department through IT? IT has a major role in any large department, particularly the Public Health Department, as we have a large manpower and also because the Government of India and the Ministry of Health is coming up with new programmes to bridge the gaps in public health service delivery every year. IT is an important tool for good governance.
How do you see the role of IT in promoting citizen services? India today has become tech savvy and that is can be evidently seen in the youth who use mobile phones to spread information at a vast level, through social networking etc. IT can be used to spread messages and awareness at a fast pace and on a large-scale. In the health sector, one can download information about a disease, it cure, prevention and also know where to get examined, all on the click of a button. That is the power of IT and the good thing for the government today is that they can spread information at a much faster sped compared to the earlier days. The other advantage is getting the information that one has missed out on. One can simply type and the information is there in front of him. I feel that information accessibility has touched new levels and only a
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facing difficulties in implementing eOffice and eChoupal programmes due to absence of basic facilities like proper power supply, network coverage, etc. These amenities have to be put in place before moving on to the next level. Personally, I have used a cloud to host my personal data but officially there are many challenges to overcome before its smooth going.
What is your vision for e-governance?
The mobile phone has brought a revolution in the way India worked and thought until recently... Any and every opportunity to piggyback the m-revolution should be lapped up with both hands citizen who is aware of the technological changes going around him would be able to avail the services to full extent, just at the click of a button from the comfort of one’s home. I also believe that this is a path-breaking change as it enables us, the people in government, to spread information.
all the important data such as number of employees, records of institutions etc and putting those on the website. We are also planning to create programmes for better analysis of data as the data we’ve amassed is huge. From data analysis we would be able to know what should be our key focus areas.
The health department has a major role in the rural areas. Is it difficult to get connectivity there to provide services?
What steps has your department taken towards incorporating the concepts of big data and cloud?
Yes, connectivity is one of the major issues we have to face in providing services in the rural areas. I have visited the BSNL in this regard, but bringing the whole country on IT map is not all that easy. The second challenge is convincing the people to use the system after it has been set up. Constant reminder is necessary to tell them the ease it offers. We need to overcome these two challenges.
We are still struggling to get Wi-Fi zones in our areas of operation and
Where do you think you stand today with regard to e-governance? I think we’ve fared well. We’ve collected
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India today has become tech savvy and that can be evidently seen among the youth who use mobile phones to spread information at a vast level, through social networking etc. IT can be used to spread messages and awareness at a fast pace and on a large-scale
Paperless offices, a smart corporate style of working, a place where information can be availed easily by a large number of people would together form my vision. Apart from that proper analysis of data would be my key focus area. I would like to go down to the block level of our administration and see what diseases are prevalent in which area, what drugs are being used, whether we are deploying proper doctors for the job, and so on. I believe we have not fully exploited ICT for awareness generation. We will have to design it in a people-friendly manner.
You often talk about using mobile platform for delivery of services. Do you see e-governance transforming into m-governance? Definitely, as I said before, the mobile phone has brought a revolution in the way India worked and thought previously. Any and every opportunity to piggyback the m-revolution should be lapped up with both hands. Nowa-days as people including women have started going to office, the question of watching TV for information doesn’t arise. But with mobile phones, it’s a different story. I believe through phone, one can connect with an individual at a personal level which is a powerful way of conveying a message.
Please tell us about your other e-initiatives. We are trying to make our website
user friendly, so that not only us but even the common man is able to use the website with ease. We are also developing a system to check the performance of our employees, whether they are getting training properly and being paid in a proper manner. We are also in the process of designing medical reimbursement software, so as to analyse how many times an individual seeks medical reimbursement, whether the reimbursement is for him or for his family, what is the disease that he seeks reimbursement for, etc. All this will give us a view of the disease profile of an individual. Once the information is gathered we can spread awareness on prevention, cure and a whole lot of other things.
Do these initiatives depend on private service providers also? No, we rely on MahaOnline and the IT Department, which have been of great support. Recently we requested purchase of tablets for senior officers so that they can access information and store data when needed.
In order to make IT a part of our office life, one can follow the examples of young people in the corporate sector, who with their laptops, tablet and mobiles are always connected, and hence their productivity is very high Going paperless is one of our key focus areas. When a fire broke out in the Mantralaya, we lost a huge number of records all on paper, but once one goes digital, the storage space required would be much less, one can access and re-access infor-
mation as many number of times required. Collaborating with private entities requires a lengthy process. So, rather than floating tenders for the private players, it is better to make use of your own IT Department.
Is capacity building a concern in implementing such technologies? Yes, it is a concern, but we don’t have any initiatives as of now but we have been giving training to different cadres for the ongoing processes. Training requires both budget and time, so currently as Maharashtra elections are at hand, we are giving only needbased training at the moment. From next year, we will be having a more coordinated training policy in place.
Any suggestions for enhancing the use and scope of these technologies? What works best for us in these situations is insisting people to do it and not leaving it as an option. In order to make IT a part of our office life, one can follow the examples of young people in the corporate sector, who with their laptops, tablet and mobiles are always connected, and hence their productivity is very high. But, for the same to happen in the government, it is necessary to provide the right environment. For example, one is able to use laptop and tablets at airports and airplanes freely, as Wi-Fi is freely available there; but imagine doing the same in a local train. To enable such services, one needs to have an environment and the right facility.
november / 2014 ehealth.eletsonline.com
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Viewpoint
Technology in Healthcare
Maharashtra Initiatives and Success Stories
Dr Sailesh Puntambekar, Managing Director, Galaxy Care Hospital, Pune shares his excitement about the new age technology tools available at the hands of a surgeon at Maharashtra Healthcare Leadership Summit 2014, Pune
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echnology is in-built in healthcare, thus it makes an exciting subject for medical practitioners across various fields in medicine. This when taken into perspective of the role of technology to us, as a surgeon – there is a rapid pace of technology revolution in treatment modalities. The biggest revolution that is taking place through technology is that a lot of surgeries today are done only through a key-hole. If you ask one doctor today what is his ultimate aim when performing surgeries, the chances are high to hear that he wants to perform a scar-less surgery. This has gained significance in many specialties.
Key-hole Surgery When it comes to scar-less surgery, it is usually accepted that except for the delivery of a new born baby that can be taken out of the uterus only and needs a wide slit, there is no organ that cannot be taken out by a key-hole technology. So much so, that we are now advanced to the technology that is called Robotic Technology. These are disruptive technologies that breaking the age old myth of big surgeons takes big incisions in surgery. The pace of technology has accelerated to such an extent that today the usual trend is that big surgeon takes no incisions. The biggest surgeons in the world do
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not take incisions; they approach the organs through various orifices and off course through key-hole incisions. The transformation that has come at the hands of the surgeon is in the form a magnification technology. Initially, surgeons used to see and cut incisions based on their assessment and experience. However, with the advent of advanced technology today, any surgeon sitting on the console, actually sees 40 times magnified image; as a result of which they are empowered with high precision and can cut better as they
see better. The improvement in visualization directly results in better surgery and subsequently faster recovery of the patient.
Robotic Surgery The most important thing that technological innovations have brought in is Robotic Surgery. Robotic Surgery is that which leads to a huge number of computer-aided surgeries. Patients tend to view surgeons is different light as compared to other decisions in healthcare. Surgeons broadly can be
divided as good, excellent and average. Firstly, the extremely intelligent surgeons but lazy, second comes the ones who are extremely intelligent and hard-working ones, who are the best of the above two category. Thirdly, there are surgeons who are extremely docile and lazy, with no harm to the society. Fourth category consists of the surgeons who are extremely enthusiastic but with do feel motivated to keep with the times and promote archaic practices amongst patients. They are harm to the society. There is hardly any possibility for the patient to know that he will receive the best of the healthcare, as he has blind faith to his surgeon. So, there is a need to have a kind of machine that is intelligent and can be easily operated that will bridge the gap between of having the skills or absence of them. This is where the robot technology in medicine becomes relevant, as the technology helps us to have a better surgery done irrespective of which category of surgeon one is and his skill-sets and the type of surgery. This is a kind of total integration of the surgical care and this is in existence in Pune city besides being utilised world-wide. The surgeon is only human and has limitations on the number of surgeries it can perform to perfection. Robotic surgery brings on-board robot machines that are precise to provide a 40 times magnified picture, thus ensuring of maximum accuracy and utmost smoothness, during surgeries. So when we can define, magnify and see clearly the organ, there remains hardly or minimum chances of damage. So, as suggestive technique and assistive tool a technological innovations or machinery that may replace an individual surgeon with optimum accuracy is more far-sighted.
Minimally Invasive Surgery To become good doctors, it is mandatory to do precise and excellent surgeries without any emotional attachment, irrespective of time. This
is with reference to ‘Minimal Invasive Surgery’. There are several types of surgeries that we can do. One must be wondering is it possible to bring out the organs in the chest or the abdominal cavity, because there are cavities which are present here. But, technologies are advanced to such an extent that we can take out organs like thyroids, sub-mandibular glands, varicose veins, and organs in the legs or operate through the vagina to reach the gall-bladder. As a matter of fact, today through a small umbilicus or the naval we may insert multiple instruments to get clear magnified picture and even complete a surgery. Ten years down the line, this scenario was something unimaginable. Today it’s a fact that the only limitation in doing this kind of surgery, does not lie in the instrumentation but lies in the
exact organ and informs you if there is an artery or vein or the critical condition of any organ. As a matter of fact a surgeon may instruct his assistant to complete the process by marking the area to be operated. However, when this technology was first introduced in Pune it was not widely accepted, highlighting of the risk factor associated in the doctor being closely associated with patient during the surgery, which may cause harm to the patient while the doctor is somewhere outside. This is completely fallacious and we are doing the surgery with extreme magnifications. Thus, these Robotic surgeries can be done much easily with the robots available for the purpose. Actually, the robot and the surgeons are in a synergistic relationship to ensure the patient gets the best benefit. The robotic technology in medicine was first embraced in the country in 2009 and we had the fifth robot in the country. After a continuous five years perusal, we only have a number of 26 robos in the entire country.
We have reached the era, where the surgeon becomes face-less; surgeries are very safe, Futuristic Technologies It is very important to have this adguaranteed and fruitful surgeons mindset. If the surgeon has a positive mindset and believes that he can successfully operate then it is possible to get the best of the results.
Orifice Assisted Single Incision Surgery In Orifice Assisted Single Incision Surgery (OASIS), there is a huge difference between the demand and supply scenario in this sector. There are excellently skilled surgeons but the gap remains not because one does not want to do it but because one can’t do it. So there is a huge mis-match between having skilled surgeons and not having skilled surgeons. Unfortunately, the demand has gone extremely high. In addition to that there is an integrated Robotic Surgery, which actually guides you to
vanced machinery so much so as surgeon can operate a patient at their convenience and at the convenience of the patients.. Some of the key features of robotic surgeries are the doctor needs not to be in close association with the patient during the surgery and can be done both being located else-where. The doctor may tele-monitor the patient and the first of the kind of similar surgery was done Trans-Atlantic and was named after the pilot who flew the aircraft for the doctor and is called ‘Lumbar’s Operation’. As a matter of fact, the future of surgery is ‘man-less surgeries’, wherein 180 of them had been done without the doctor present on the spot of operation. We have reached the era, where the surgeon becomes face-less, surgeries are much safe, guaranteed and fruitful.
November / 2014 ehealth.eletsonline.com
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Viewpoint
Healthcare Insurance
Should be Inclusive
Says Joy Chakraborty, COO, P D Hinduja Hospital & Medical Research Centre, Mumbai as he sketches the delicate relationship among government, insurance providers, hospitals and patients
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aking healthcare affordable and accessible to all is a mandate that many healthcare providers and stakeholders take but many actually work on ground realities and make them meaningful. There are multiple players who have an important role in making health
insurance for all a reality in India. And, there is a need for balance in the relationships among insurance companies, government, agencies, as well as the private and public operators. Their efforts will help us make quality healthcare accessible and affordable.
Innovation is Dire Need Insurance is a pre-payment mechanism where the insurer is covered for the risk for whatever they are likely to face in future. In the Indian scenario, most of the time the medical cover is offered by the government insurance schemes or private insurance companies. We also have social insurance in place, and in these we find that mostly Employees State Insurance Scheme (ESI) is a provider. In all these, there is still a gap in the promises made and quality of service delivered by health companies in India. It is somewhere in that perspective that it is seen as a high risk support, where the quality as well the cost contribution mechanism have a mismatch to the patients’ expectations.
Challenges Market coverage is very less as of date in Maharashtra and has lot of issues and challenges. The role of the consumer or the patient is much needed to make these schemes successful. We try to keep ourselves away from a health agent and casual approach towards our health likelihood of illness. We should be proactive about our health. Market penetration is also low and more efforts are needed. This works well
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at the last mile where micro-insurance and community insurance is likely to work best from the experience of Karnataka state and should not be left to work in isolation and fragmented. The need of the hour is customized policies for the bottom of pyramid and the micro-insurance model will connect with the people and deliver according to their needs. Another important aspect that is missing is the health insurance preventive check up if it will be given as part of the insurance package; this will have a direct impact on the direct reduction of claim amounts that are made by patients. There is a need to manage these out-patient claims and manage the overall cost of the amount that is submitted for claims, however these privileges are not there as policy structures as available today.
Breaking Myths Two myths that are there usually surrounding the realization of quality and affordability of healthcare in a developing country like India, is firstly, that quality healthcare is expensive and that it is usually believed to be affordable by only a select section of population. I would like to break that myth. There is always a way to follow a scientifically proved concept of productivity frontier that balances the operational effectiveness versus strategic positioning. This is proved scientifically and even research has been done to prove that there is an inverse relation between number of patients at a healthcare facility and cost of treatment. The increases in the number of patients have a direct impact on the cost, as the number of patients increase the cost of treatment drops. All we need to do is to follow our heart and there is no need even to compromise in ethical practice, you can give the best possible cure at best possible price. This makes it a win-win situation for both the patients and the hospitals.
Two myths that are there usually surrounding the realization of quality and affordability of healthcare in a developing country like India is, firstly, that quality healthcare is expensive and that it is usually believed to be affordable by only a select section of population Patient Wellness Quality in healthcare is important to have documented patient outcomes. The outcome based claim settlement mechanism is a system that encourages pay for quality. This system has been adopted in the US. This leads to pay for quality mandate. The system is designed in such a way that insurance companies benefit when patient outcome is good, when your patient stay is less you get more, if the patient infection rate is high you get less money. The system has an inbuilt component to monitor patient satisfaction and on the basis of your performance score wherein you have to score more or better to get better re-imbursement. This system unfortunately is not practiced in India. If such innovative practices are brought to India, it will have direct impact on the quality and affordability of healthcare. These will help insurance providers have better market penetration and acceptance by hospitals and patients alike.
Best Practices The adoption of best practices is im-
perative for healthcare sector in India to be more effective in patient care. India has high volume of patients ailing from chronic diseases. Thus introduction of disease management of chronic diseases is important need of the hour. Currently, we have there is no system where we can monitor or assist the patient in diagnostic check up for the patient for any diseases. This one important information if delivered to the patient on time can surely help reduce the probability of hospitalization and increase in amount of claims. We are also looking at formats of home care and day care that have become popular wherein the period of hospitalization is short and patients’ returns home much faster. However, as this is not supported by many insurance companies it faces the issue of patients’ volume. It would be encouraging if the insurance companies pay attention to this trend and design policies and mechanism by which insurance companies can pay such day care centre admissions and treatments. Otherwise all this become hospital-based care that is more expensive.
Inclusive Healthcare Access to quality is a privilege for few is another hypothesis and assumption. This has its basis on that less number of people can get access to better quality healthcare. This perception can be entirely changed if we follow the theory of numbers, wherein if we are able to get more number of people and reduce the cost and distribute the provisions centers or healthcare providers should be available in different locations which can make this quality healthcare accessible for many people. This will address the long standing concern of equitable distribution of healthcare. Our ultimate dream should be that those who are at the bottom of the pyramid, we need to address their needs and have better healthcare facilities accessible to them.
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Hospital news
Doctors Perform First
Day-Care Angioplasty on 55-Year-old W
hen 55-year-old Vinod Kumar was diagnosed with a blocked coronary vessel, he and his family were immediately worried about the prospects of his recovery as well as the financial costs of the hospital stay and other expenses of the procedure needed to open-up the narrowing artery. After all, the patient from Ballia town in Uttar Pradesh needed to undergo an angioplasty to correct the 85 per cent blockage in his artery to scuttle the risk of heart attack and angina. However, doctors at super-specialty Paras Hospitals, Gurgaon, led by Dr Tapan Ghose, Director & HOD, Cardiology offered a solution the patient and his family had not expected -- a coronary angioplasty that would not need an overnight stay. The ‘day care’ radial angioplasty, as the team of doctors have dubbed it, involved the admission of the patient in the morning and his discharge the same evening – the first time such a procedure has been performed in India. This successful day-long procedure not only radically cut the hospital and personal costs of the patient, but also dramatically reduced the hospital stay time. For such a procedure usually, a patient has to stay in a hospital for a minimum of three days. Vinod, however, turned out to be the lucky first patient in India to have been discharged from the hospital the same day as his procedure was conducted.
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Dr Tapan Ghose (right) led the team of doctors performing the complicated operation.
“Vinod was suffering from breathlessness and experiencing heaviness in the chest, and was recommended angiography. A post procedure diagnosis highlighted 82-85 per cent stenosis (or blockage) and he was advised PTCA angioplasty. However the patient and his family requested for the procedure to be completed in limited cost with a short hospital stay, with no compromise on the quality of the stent used for treatment,” says Dr Ghose. He also highlighted that, ““People today don’t have time. Medical conditions can be a drain on a family’s resources. Short hospital stay, less medication, less cost & highly skilled medical professionals is what
patients want. Our efforts of making CVD diagnosis & treatment day care are to achieve the same. We hope that by achieving such attributes the fear of machines, hospitals & doctors would diminish, leading to more & more people opting for preventive cardiac checkups.” Dr Ghose and his team therefore decided to address the patient’s concerns and planned to perform India’s first day-care radial angioplasty. Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure conducted to diagnose and unclog blocked or narrowed arteries in a person’s heart. Catheters or stents are inserted
through arteries into the body to open up the obstructed artery and resume the blood flow. Wrist angioplasty, also called the radial approach allows a cardiologist access to a patient’s heart through the artery in the wrist unlike the more traditional femoral approach which requires a catheter to be inserted into the heart via the femoral artery in a patient’s groin. Radial angioplasty, or angioplasty through the wrist, which was done in this case, is relatively safer and more cost effective than the traditional method of approaching the heart through the femoral artery in the groin. This approach cuts chances of complications and reduces the quantum of bleeding, enabling a faster recovery. It also allowed the patient to be discharged on the same day as the procedure was conducted, reducing
There are relatively fewer number of interventional cardiologists trained in the radial approach. It is a difficult approach which needs skill and training. But, we believe it is the need of the hour as we need to reduce hospital stays and costs for patients’ duration as well as cost of stay. Despite it being a relatively safer and faster procedure, radial angioplasty is still performed by only a limited number of cardiologists in India.
In fact, Paras Hospitals, Gurgaon is among the very few institutions in the country whose entire team of cardiologists is equipped to conduct the life-saving trans-radial approach to angioplasty. “There are relatively lesser number of interventional cardiologists trained in the radial approach. It is a difficult approach which needs skill and training. But, we believe it is the need of the hour as we need to reduce hospital stays and costs for patients and also make angioplasty a safer procedure,” says Dr Ghose. “I am thankful to Dr Tapan Ghose and his team for giving a new lease of life to me. I am also grateful to the management of Paras Hospitals, Guragon for supporting me during my treatment and subsequent expense,” says Mr Kumar.
Recognize signs of excess sugar in your blood
The bittersweet truth about diabetes in India
If you have a family history of regular fluctuation of sugar levels or if someone is suffering from diabetes in your family, it is recommended to go in for a simple blood sugar test at least two times in a year. This way you would be able to keep an eye on early signs of Diabetics. So, do you feel thirsty all day long and crave for water all the time? Constant feeling of thirst and visiting the washroom repeatedly generally indicate that there is a lot of sugar in the blood of your body. This in turn puts extra burden on the kidneys to remove the excess sugar and while doing so, they utilize fluids from the tissues of the body making it dehydrated. According to the experts, diabetics lead to frequent urination throughout the day. And when you’re visiting the bathroom very often, you also feel thirsty at the same time and end up drinking more water so that you don’t get dehydrated eventually. Another classic sign of too much blood sugar is feeling tired all the time. Too much sugar in your blood means that your cells aren’t getting enough and that in turn affects your muscles. This is what causes fatigue. Another sign of diabetes is swelling or numbness in the hands and feet. Get yourself checked by your doctor.
Indeed, diabetes is a huge health hazard in India and everyday it’s further spreading like wildfire. Even as nations prepare to celebrate World Diabetes Day on November 14, WHO studies claim about 80% of the diabetes deaths occur in middle-income countries. And about 1 million people passed away from diabetes two years ago. According to the International Diabetes Federation (IDF), India is currently home to over 61 million people with diabetes, an increase from 50.8 million in 2011. By 2030, India’s diabetes burden is expected to cross the 100 million mark as against 87 million estimated earlier. The irony of the situation is that nearly 5 out of 10 Indians with diabetes aren’t even aware that they have diabetes, a disease that exposes them to heart attack, stroke, amputations, nerve damage, blindness and kidney disease. Almost every organ in the body can be adversely affected with the onslaught of diabetes but with timely intervention and care, the disease can be contained and complications can be prevented. Diabetes affects people all over the country. Diabetes affects people both in urban and rural India though the impact on urban India is higher.
Diabetes news
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news news
Nihon Kohden becomes
the Market Leader
Nihon Kohden Dominating High-Tech Asia-Pacific Patient Monitoring Market, Chased by Philips Healthcare, GE Healthcare, and Fukuda Denshi
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ccording to a report by iData Research (http://www.idataresearch.com), the multi-parameter vital sign monitoring market segment in the Asia-Pacific region is both stable and exceptionally valuable; over the next few years, this segment will steadily approach, and eventually surpass, US$ 400 million. Those involved in multi-parameter vital sign monitoring should pay close attention to Japan, a market deeply interested in technological advancements in this industry. “With technological advancement, multi-parameter monitoring devices are increasingly being used in more diverse situations,” says Dr. Kamran Zamanian, CEO of iData. “Wireless telemetry is moving to the wayside as hospitals use more high-, mid- and lowacuity monitors. And moreover, the market for fetal and neonatal monitoring devices is expected to decline as birth rates reach historic lows.” Other key findings from the iData Research report entitled Asia-Pacific Patient Monitoring Market include: Key Physician Values for Patient Monitoring Devices
Health IT Clinically, there is a demand for high performance devices with appealing features. Devices with connectivity abilities can display integrated information from different devices across the hospital, and from the hospital information system. This allows physicians to have a complete patient
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ences in the expected performance of the wireless ambulatory telemetry monitor markets in the Asia-Pacific region. The South Korean and Australian markets are expected to perform well over the forecast period. The importance of mobilizing patients post-surgery has been widely acknowledged across Australia, and use of telemetry monitoring will continue to grow. In South Korea, a preference for sophisticated, higherpriced products will drive increases in the ASP of the market.
“The multi-parameter vital sign monitoring market segment in the Asia-Pacific region is both stable and exceptionally valuable.” By 2020, the technologically driven patient monitoring equipment market is projected to be worth more than US$ 680 million, with Japan representing more than 75% of that value, reports iData Research profile from a single point of access. Monitors with large touch screens will become more popular, as they make it easier to display and use patient data.
Regional Differences for Wireless Ambulatory Telemetry Monitors There are striking regional differ-
Greater Attention to be placed on Replacement Sales The Asia-Pacific patient monitoring market is characterized by mature market segments that are driven primarily by replacement sales. Growth rates within particular regions and market segments vary, depending on local policies, hospital investment and preferences. However, some market growth can be expected due to the need to equip new hospitals in South Korea. The market for patient monitoring equipment in the Asia-Pacific region is highly concentrated, with the four leading competitors controlling over 75% of the market. However, a large number of smaller competitors are gaining market share. The four major players are Nihon Kohden, Philips Healthcare, GE Healthcare and Fukuda Denshi, with Nihon Kohden controlling a much larger share than the other three.
news
Hitachi develops technology to extract designated info from EMRs
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itachi team won 1st prize in a technical competition held by a European research forum for extraction of appropriate medical information from electronic medical records (EMRs) by achieving 86.8 per cent precision. Hitachi India Pvt Ltd and Hitachi Ltd have announced that they have developed a technology to extract precisely designated information from electronic medical records with International Institute of Information Technology, Hyderabad (IIIT-H). The technology makes it possible to analyze electronic medical records including various mixed forms such as free-form texts written by doctors or laboratory data written in given formats. It is expected that more advanced medical services will be realized by that, such as prediction of the incidence rate of diseases in the future. Hitachi India, Hitachi and IIIT-H won 1st prize with an extraction precision of 86.8% in CLEF(1) e-Health 2014 Task2(2), a technical competition on medical information extraction, which was held by a European Research Forum CLEF from January to May 2014.
Chronic fatigue: structural abnormalities found in patient’s brain
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recent study, published in the journal Radiology, led by Dr. Michael M. Zeineh from Stanford University School of Medicine in California found that structural abnormalities exist in the brains of those patient suffering from chronic fatigue. According to the Centers for Disease Control and Prevention (CDC), over 1 million adults in the US are affected by chronic fatigue syndrome Because there is no single test to identify the condition, diagnosis includes ruling out other conditions for which fatigue is an evident symptom. “It’s very frustrating for patients,” says Dr. Zeineh, “because they feel tired and are experiencing difficulty thinking, and the science has yet to determine what has gone wrong.” Aside from severe fatigue, individuals with CFS can experience muscle pain, impaired memory or mental concentration, insomnia and post-exertion weakness. What is more, the condition can last for years in some cases. Though scientists have not yet identified a specific cause of CFS, one theory is that it could have multiple triggers, including: infections, nutritional deficiency, immune dysfunction, stress that activates the HPA axis – the axis where the hypothalamus, pituitary and adrenal glands interact – and abnormally low blood pressure.
Knowing Cancer risk may not affect screening rates
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When researchers examined people for a genetic mutation that raises the chances for colon cancer, they thought that informing people of their heightened danger would help them to get the much needed screening, but they were wrong. Scientists studied 783 people older than 50 years of age, the age when screening is actually suggested for all, who were not being checked ever since the study began. Two-thirds of them received advice about colon cancer screening, a session of genetic counseling and a blood test that could tell them whether they were at average or increased risk for colon cancer. The other third received only the advice about the advantages of screening. The study was published in the November issue of The Annals of Internal Medicine by the medical experts.
Why do doctors fear of Ebola outbreak?
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he recent incidents of Ebola outbreak and related in Africa has been making headlines across the world. However, Dr. Seth Berkley, CEO of the GAVI Alliance often wonders as to why this disease is so deadly as compared to other deadly diseases present in the world. He suggests it’s because people in the west have forgotten what it is like to deal with an untreatable disease.It starts with familiar flu-like symptoms: a mild fever, headache, muscle and joint pains. But within days this can quickly descend into something more exotic and frightening: vomiting and diarrhoea, followed by bleeding from the gums, the nose and gastrointestinal tract.We have simply forgotten what it is like to live under threat of such infectious and deadly diseases, and forgotten what it means to fear them” november / 2014 ehealth.eletsonline.com
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news
Vegetative patients show signs of consciousness
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arious medical experts have unveiled several signatures in the brains of people in vegetative states that shows signs of slight consciousness. Doctors generally hold these patients that have critical brain injuries – being unaware of the world around them although they remain awake. Researchers hope their work will help identify those who are actually conscious, but unable to communicate. Their report appears in PLoS Computational Biology. Awake but unaware After catastrophic brain injuries, for example due to car crashes or major heart attacks, some people can appear to wake up yet do not respond to events around them. Doctors describe these patients as being in a vegetative state.
How do authorities determine time and cause of death?
Human cells to tissue-engineered esophagus
or some few days, the news has been dotted with revelations about some of the very high profile deaths of Joan Rivers and Misty Upham, and time and cause of death are most crucial aspects of these cases. Now the question comes, How can the authorities determine these crucial factors? Greg McDonald, director of forensic medicine, says several factors come into play during an investigation such as this. “There are a lot of things at the scene that can give us clues; levels of rigor mortis (stiffness), and also algor mortis (cooling of the body) and livor mortis (pooling of the blood). Also, stomach contents, and the presence of insects at the scene can all give us a picture of when and how a person died. McDonald is basically a board certified in Anatomic and Forensic Pathology; he currently serves as a chief consultant for the Montgomery County Coroner’s Office in Pennsylvania, an formerly served in the Philadelphia Coroner’s Office.
n the first of is kind, for all types of human therapies, researchers at The Saban Research Institute of Children’s Hospital Los Angeles have come up with that esophageal tissue which can be grown in vivo from both human and mouse cells. The study has been published on the internet in the name of journal Tissue Engineering, Part A. The tissue-engineered esophagus formed on a relatively simple biodegradable scaffold after the researchers transplanted mouse and human organ-specific stem/progenitor cells into a murine model, according to principal investigator Tracy C. Grikscheit, MD, of the Developmental Biology and Regenerative Medicine program of The Saban Research Institute and pediatric surgeon at Children’s Hospital Los Angeles. Progenitor cells have the ability to differentiate into specific types of cells, and can migrate to the tissue where they are needed.
F
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Patients typically open their eyes and look around, but cannot react to commands or make any purposeful movements. Some people
remain in this state for many years. But a handful of recent studies have questioned this diagnosis – suggesting some patients may actually be aware of what is going on around them, but unable to communicate. A team of scientists at Cambridge University studied 13 patients in vegetative states, mapping the electrical activity of their nerves using a mesh of electrodes applied to their scalps. Dr Srivas Chenn, and Sandra Bell whose son is in a vegetative state, spoke to Today The electrical patterns and connections they recorded were then compared with healthy volunteers. The SARMS consisted of 11 items—six evaluating microsurgery skills and five evaluating robotic skills.
November / 2014 ehealth.eletsonline.com
I
event preview
India’s Premiere Hospital
Infrastructure Show Returns A s the overall investment in the Indian healthcare infrastructure segment continues to grow, the region’s leading event, Hospital Infrastructure and Management (HIM) is all set to provide the perfect platform for companies aiming to win tenders, drive sales and increase their market share in infrastructure, construction, fit-out and management between 12th – 14th December, 2014 at Bombay Exhibition Center from 10:00am onwards. Hospital Infrastructure and Management (HIM)is projected to be the most credible trade fair witnessed by the hospital industry with validated industry buyers including key budget holders, policy makers and investors in healthcare projects visiting the show;they represent the real power behind this thriving industry. Hospital Infrastructure & Management India, will be held in the booming city of Mumbai, and is set to be bigger than ever with over 100 exhibitors covering over 5,000sqm of exhibition floor space, and an estimated 4,000+ trade visitors. The healthcare industry in India has witnessed a massive increase in investment, as is particularly evident by the rising number of public and private hospitals, military hospitals, clinics and specialty centers that have been constructed and developed across the country over the last few years. Hospital Infrastructure & Management (HIM) will raise the benchmark for the hospital industry with leading and relevant names at the show, because it’s here where ‘Decision Makers Get Together; and Business Happens’.
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November / 2014 ehealth.eletsonline.com
The healthcare industry in India has witnessed a massive increase in investment, as is particularly evident by the rising number of public and private hospitals, military hospitals, clinics and specialty centers that have been constructed and developed across the country over the last few years. Hospital Infrastructure & Management (HIM) will raise the benchmark for the hospital industry with leading and relevant names at the show “We strive to make Hospital Infrastructure & Management an exceptional experience and platform for the Indian hospital industry for the latest developments, trends, equipmentand launches. We have attempted to create a knowledge-sharing platform and pave the way to discover the latest trends and techniques which have emerged in current times and we look forward to further supporting India’s
healthcare industry to grow further.” said Mr. Vikas Vij, MD, The Ideas Exchange, organizers of HIM. Register now on the website, visit www.hospitalinfra.co.in For more information contact: Khyati Mishra Marketing Manager khyati.mishra@ideas-exchange.in Telephone: +91-22-6171-3211
Inviting participation for School Ranking 2014
Top Schools of India In a world living to the Darwinian maxim of survival of the fittest, school education is not limited to the realm of academics alone. Are you a school that believes in keeping the child at the centre of it all? Do you believe you have it in you to prepare children for success not just in terms of education, but also in their well-being, skills and social integration? If so, nominate your institute for the prestigious digitalLEARNING School Ranking that seeks to recognise and honour the best from across the country.
Academic Excellence Start-up Infrastructure Minority Education ICT Implementation International Curriculum Boarding To fill ranking questionnaire, pls visit http://digitallearning.eletsonline.com/school_ranking/
Highlights The ranking will cover schools from the metros, as well as the Tier II and Tier III cities across 29 states and 7 union territories of the country. Felicitation for top-ranked schools at the School Leadership Summit in January 2015 The best ranked schools will be felicitated at the School Leadership Summit in January, 2015. This summit will host top Indian schools and educators, educationists, providing an excellent platform to network and collaborate with each other, helping achieve the next level of growth. To see school ranking 2013, Pls Visit http://digitallearning.eletsonline.com/2014/01/presenting-top-schools-of-india-december-2013/
For queries and participation, please contact Seema Gupta, mobile - +91 8860651643, mail - seema@elets.in Nidhi Sharma, mobile - +91 8860651631, mail - nidhi@elets.in
Last date for submission of forms 15-November-2014